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Clin J Pain. 2016 Feb;32(2):179-85. doi: 10.1097/AJP.0000000000000218.

Effect of Perioperative Vitamin C Supplementation on Postoperative Pain and the Incidence of Chronic Regional Pain Syndrome: A Systematic Review and Meta-Analysis.

Author information

1
*University of Ottawa Spine Program, The Ottawa Hospital §Faculty of Medicine, University of Ottawa Divisions of †Neurosurgery ∥Orthopaedic Surgery, The Ottawa Hospital ‡Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.

Abstract

OBJECTIVES:

Postoperative pain can contribute to increased risk for complications and lengthened hospital stays. The objective was to analyze the effects of perioperative vitamin C supplementation on postoperative pain and the development of complex regional pain syndrome I (CRPS I) in patients undergoing surgical procedures.

MATERIALS AND METHODS:

A systematic review of published literature was performed through April 2014. References from relevant studies were scanned for additional studies. Results were screened for relevance independently, and full-text studies were assessed for eligibility. Reporting quality was assessed using a modified Newcastle-Ottawa Scale.

RESULTS:

The search strategy yielded 710 studies, of which 13 were included: 7 on postoperative pain and 6 on CRPS I. In the final analysis, 1 relevant study found a reduction in postoperative morphine utilization after preoperative vitamin C consumption, whereas another showed no difference in postoperative pain outcomes between the vitamin C and control groups. A meta-analysis of 3 applicable CRPS I studies showed a decrease in postoperative CRPS I after perioperative vitamin C supplementation (relative risk=2.25; τ²=0).

DISCUSSION:

There is moderate-level evidence supporting the use of a 2 g preoperative dose of vitamin C as an adjunct for reducing postoperative morphine consumption, and high-level evidence supporting perioperative vitamin C supplementation of 1 g/d for 50 days for CRPS I prevention after extremity surgery. Additional studies are necessary to increase the level of evidence to determine the overall effectiveness and optimum dosage of vitamin C.

PMID:
25654537
DOI:
10.1097/AJP.0000000000000218
[Indexed for MEDLINE]

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