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Background: The role of pre-emptive analgesia in major surgeries have shown conflicting results. The present systematic review evaluates the role of pre-emptive analgesia on pain relief in patients who undergo orthopaedic surgery in the elective and emergency setting. Methods: In 2020, a search was carried out in electronic databases to find trails and research papers in relation to pre-emptive analgesia in orthopaedic surgery (PubMed, Cochrane, Medline). Inclusion and exclusion criteria were applied. Inclusion criteria included trials that evaluated the use of pre-incisional analgesia against a placebo, surgery had to be specific to orthopaedic specialty and recording of post-operative pain intensity had to be carried out. Results: The initial result yielded a total of 168 results. After removing duplicates, and papers which didn’t fit the inclusion criteria, the total amount of trials analysed in this systematic review was 22. The remaining trials were categorised by surgery and analysed. Of the 22 studies, nineteen trials supported the use of pre-emptive analgesia in orthopaedic surgery whereas three did not. Conclusions: Pre-emptive analgesia has an important role in post-operative pain relief in orthopaedic surgery. From the studies analysed in this review, many support the use of pre-emptive analgesia to provide post-operative pain relief and in addition decrease post-surgical analgesia consumption.

AB089. SOH21AS069. A systematic review of pre-emptive analgesia in orthopaedic surgery