Systematic review and meta-analysis of interventions for postoperative fatigue
Article first published online: 29 NOV 2002
© 2002 British Journal of Surgery Society Ltd
British Journal of Surgery
Volume 89, Issue 8, pages 971–984, August 2002
How to Cite
Rubin, G. J. and Hotopf, M. (2002), Systematic review and meta-analysis of interventions for postoperative fatigue. Br J Surg, 89: 971–984. doi: 10.1046/j.1365-2168.2002.02138.x
- Issue published online: 29 NOV 2002
- Article first published online: 29 NOV 2002
- Manuscript Accepted: 15 MAR 2002
Postoperative fatigue is common, even after uncomplicated operations. Various theories have been presented regarding its aetiology, each suggesting different possible interventions. The purpose of this review was to identify all studies that have assessed interventions for postoperative fatigue and to evaluate these interventions using meta-analytical techniques.
Randomized controlled trials of interventions, identified from a systematic search of relevant databases, were evaluated according to standardized criteria and categorized according to intervention modality. Data relating to the efficacy of each intervention at four different postoperative time-points were collated and data synthesis by meta-analysis was performed.
Analgesia is effective in reducing fatigue immediately after operation. Perioperative administration of human growth hormone reduces fatigue between 8 and 30 days after abdominal surgery. Weaker evidence was found to suggest an influence of glucocorticoid administration and of surgical technique on fatigue in the first week after operation. No evidence was found to support the theory that psychosocial or nutritional interventions affect the symptom.
While the results demonstrate that improved analgesia can attenuate immediate postoperative fatigue in most patient groups, further research is needed to determine whether the efficacy of human growth hormone and glucocorticoids extends beyond abdominal surgery. The paucity of research into cognitive–behavioural, sleep and activity-based interventions also needs to be addressed. © 2002 British Journal of Surgery Society Ltd