Meta-analysis topic ideas in anaesthesia and pain medicine
Anaesthesia has a very large trial literature, in part because a drug or a nerve block can be tested within a single operating list. That produces hundreds of small randomized comparisons of drugs, blocks and techniques, many from single centres. The literature is easy to pool, but it also contains retracted and unreliable trials.
A good review in this field therefore does two things: it picks a narrow, clinically meaningful comparison, and it checks the trials for reliability, not only for risk of bias.
Find a anaesthesia and pain medicine topic that has not been done
SynthGap searches the published literature, checks each candidate against existing systematic reviews, and proposes topics with the primary studies behind them. Start on the Free plan: no card needed, and every run shows every topic it finds.
Sign up freeWhere gaps tend to hide in anaesthesia and pain medicine
Regional anaesthesia techniques
Newer fascial plane blocks are compared with older blocks, with wound infiltration, or with no block, for many different operations. A review per operation or per block type is common, and doses of local anaesthetic vary a lot.
Adjuncts and opioid-sparing analgesia
Dexmedetomidine, ketamine, magnesium, lidocaine infusions and gabapentinoids are studied for postoperative pain, delirium and chronic pain, with varied doses.
Postoperative outcomes beyond pain
Delirium, nausea and vomiting, cognitive change and chronic post-surgical pain are secondary outcomes in many trials and are rarely pooled with attention to definitions.
Airway and perioperative management
Videolaryngoscopy, preoxygenation strategies and fasting guidance have trials with different populations and outcomes such as first-pass success.
Chronic pain
Neuromodulation, injections, and psychological and physical therapies for chronic pain have small trials and large placebo effects. Reviews that pool by condition and by outcome domain are needed.
Outcomes and effect measures that pool well in anaesthesia and pain medicine
- Pain scores on a 0 to 10 scale at stated times (for example, 2, 24 and 48 hours): mean differences, pooling each time point separately.
- Opioid consumption: convert to oral morphine equivalents, report the conversion used, and avoid pooling different time windows.
- Nausea, vomiting, delirium and other binary events: risk ratios, with a method suited to rare events.
- Time to first rescue analgesia and block duration: mean differences. They are usually skewed, so check how medians were handled.
- Chronic pain at three or six months: risk ratios for the proportion with pain and mean differences for intensity. Loss to follow-up is often high.
Common traps in anaesthesia and pain reviews
- Including trials from single centres that have been flagged for data integrity concerns or that have been retracted.
- Pooling pain at different time points without stating which.
- Comparing different local anaesthetic volumes and concentrations as one block.
- Relying on very short-term outcomes, such as pain at two hours, when the clinical question is recovery.
- Poor blinding when the block is obvious to the patient and there is no sham block.
Check before you commit
Before committing months to a topic, check that nobody has beaten you to it. Search PubMed with its systematic review filter, the Cochrane Library, the PROSPERO register (for reviews that are registered but not yet published) and Epistemonikos. Look at how recent the latest review is and whether new trials have appeared since its search date. Step-by-step guide.
Starting points to try in SynthGap
These are areas to explore, not claims that they are open. Some may already be well covered, and finding that out quickly is the point.
- Fascial plane blocks versus standard techniques for a specific operation, with attention to dose
- Perioperative lidocaine infusion and recovery after abdominal surgery
- Interventions to prevent chronic post-surgical pain after breast surgery
Questions
How do I handle trials that might be unreliable?
Check for retractions, expressions of concern and implausible data, and consider a sensitivity analysis excluding trials with integrity concerns. Several tools for assessing the trustworthiness of randomized trials have been published; say which one you used.
How do I check whether an anaesthesia meta-analysis already exists?
Search PubMed with the systematic review filter, the Cochrane Library (Cochrane Anaesthesia, Critical and Emergency Care publishes many reviews), PROSPERO and Epistemonikos.
Can I pool different local anaesthetic doses?
Only if you have a reason to think the effect is similar. Otherwise group by dose range, or use meta-regression if enough trials report the dose.
Other specialties
This page is general methodological guidance, not medical advice, and it does not list specific unreviewed topics. SynthGap's suggestions are AI-generated from the published literature, so verify them before registering a protocol.