The impact of perioperative vitamin C on postoperative pain: A systematic review and meta-analysis
In brief
Perioperative vitamin C cuts 24-hour morphine use by ~4 mg
A meta-analysis of 27 trials (3,041 patients) found that giving vitamin C around surgery lowered pain scores and reduced morphine consumption by about 4 mg in the first 24 hours and nearly 12 mg by 48 hours, while also halving the need for rescue analgesia and postoperative nausea.
- Journal
- Journal of clinical anesthesia (Q1)
- Published
- 7 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Jialin Xiong, Yuxuan Yang, Qiang Zhang, Kongyan Wu, Yuhuan Gong, Jie Luo
- PMID
- 42705006
- DOI
- 10.1016/j.jclinane.2026.112309
Why clinicians should know about it
- Picked for Surgery (top studies of the week, 13 September 2026): Vitamin C meta‑analysis, pain focus
- Picked for Anesthesiology and Pain Medicine (paper of the day, 8 September 2026): Peri‑operative vitamin C reduces acute pain and opioid use
Abstract
OBJECTIVE: To evaluate the effects of perioperative vitamin C on postoperative pain, opioid consumption, and other clinically relevant outcomes. METHODS: We systematically searched PubMed, Web of Science, Cochrane Library, Embase, and ClinicalTrials.gov from inception to December 2025, and included randomized controlled trials (RCTs) that assessed perioperative vitamin C administration in patients undergoing surgery. RESULTS: 27 RCTs with 3041 patients were included. Perioperative vitamin C reduced postoperative pain at 24 h (SMD = -0.69, 95% CI: -0.98 to -0.40) and decreased 24-h morphine consumption (MD = -4.25 mg, 95% CI: -6.14 to -2.35), with a greater opioid-sparing effect at 48 h (MD = -11.70 mg, 95% CI: -14.18 to -9.21). It reduced the need for rescue analgesia (RR = 0.63, 95% CI: 0.47 to 0.84) and lowered the incidence of postoperative nausea and vomiting at 1 h (RR = 0.48, 95% CI: 0.29 to 0.79). Furthermore, the risk of postoperative complex regional pain syndrome-1 (CRPS-1) was reduced (RR = 0.36, 95% CI: 0.23 to 0.58), whereas the reduction in chronic pain at 3 months did not reach statistical significance. No significant effects were observed on hospital stay or intraoperative blood loss, and no serious adverse events related to vitamin C were reported. CONCLUSIONS: Perioperative vitamin C may be associated with reduced acute pain and opioid consumption, with a favorable safety profile, although these findings were limited by substantial heterogeneity and publication bias. Vitamin C showed a potential protective effect against postoperative CRPS-1 in high-risk orthopedic populations. Current evidence is insufficient to support routine clinical recommendation of vitamin C for acute pain management, and more standardized high-quality RCTs are needed to better confirm its benefits. KEY MESSAGE: This meta-analysis suggests that perioperative vitamin C may reduce acute postoperative pain and opioid consumption, but evidence is limited by heterogeneity and publication bias.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.