Article Text

other Versions

Download PDFPDF
Core outcome set for peripheral regional anesthesia research: a systematic review and Delphi study
  1. Jeremy Hill1,
  2. Toby Ashken1,
  3. Simeon West1,
  4. Alan James Robert Macfarlane2,3,
  5. Kariem El-Boghdadly4,
  6. Eric Albrecht5,
  7. Ki Jinn Chin6,
  8. Ben Fox7,
  9. Ashwani Gupta8,
  10. Stephen Haskins9,10,
  11. Nat Haslam11,
  12. Rosemary MG Hogg12,
  13. Anil Hormis13,
  14. David F Johnston14,
  15. Edward R Mariano15,16,
  16. Peter Merjavy17,
  17. Timothy Moll18,
  18. James Parry19,
  19. Amit Pawa4,
  20. Kim Russon20,
  21. Maria Paz Sebastian19,
  22. Lloyd Turbitt12,
  23. Jonathan Womack21 and
  24. Maria Chazapis1
  1. 1Department of Anaesthetics, University College London Hospitals NHS Foundation Trust, London, UK
  2. 2Glasgow Royal Infirmary, Glasgow, UK
  3. 3University of Glasgow, Glasgow, UK
  4. 4Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, UK
  5. 5Department of Anaesthesia, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
  6. 6Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada
  7. 7Department of Anaesthesia, Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, UK
  8. 8Anaesthetics, Gateshead Health NHS Foundation Trust, Gateshead, UK
  9. 9Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery Department of Anesthesiology Critical Care & Pain Management, New York, New York, USA
  10. 10Department of Anesthesiology, Weill Cornell Medical College, New York, New York, USA
  11. 11City Hospitals Sunderland NHS Foundation Trust, South Shields, UK
  12. 12Department of Anaesthesia, Belfast Health and Social Care Trust, Belfast, UK
  13. 13Department of Anaesthetics, The Rotherham NHS Foundation Trust, UK, Rotherham NHS Foundation Trust, Rotherham, UK
  14. 14Belfast Health and Social Care Trust, Belfast, UK
  15. 15Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, Palo Alto, California, USA
  16. 16Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA
  17. 17Anaesthetic, Craigavon Area Hospital, Portadown, UK
  18. 18Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  19. 19Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK
  20. 20South Tyneside and Sunderland NHS Foundation Trust, South Shields, Tyne and Wear, UK
  21. 21Royal Victoria Infirmary, Newcastle upon Tyne, UK
  1. Correspondence to Dr Jeremy Hill, Department of Anaesthetics, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; jeremy.hill1{at}


Background/importance There is heterogeneity among the outcomes used in regional anesthesia research.

Objective We aimed to produce a core outcome set for regional anesthesia research.

Methods We conducted a systematic review and Delphi study to develop this core outcome set. A systematic review of the literature from January 2015 to December 2019 was undertaken to generate a long list of potential outcomes to be included in the core outcome set. For each outcome found, the parameters such as the measurement scale, timing and definitions, were compiled. Regional anesthesia experts were then recruited to participate in a three-round electronic modified Delphi process with incremental thresholds to generate a core outcome set. Once the core outcomes were decided, a final Delphi survey and video conference vote was used to reach a consensus on the outcome parameters.

Results Two hundred and six papers were generated following the systematic review, producing a long list of 224 unique outcomes. Twenty-one international regional anesthesia experts participated in the study. Ten core outcomes were selected after three Delphi survey rounds with 13 outcome parameters reaching consensus after a final Delphi survey and video conference.

Conclusions We present the first core outcome set for regional anesthesia derived by international expert consensus. These are proposed not to limit the outcomes examined in future studies, but rather to serve as a minimum core set. If adopted, this may increase the relevance of outcomes being studied, reduce selective reporting bias and increase the availability and suitability of data for meta-analysis in this area.

  • analgesia

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Twitter @ajrmacfarlane, @elboghdadly, @ashwani_doc, @rosie_hogg, @anilhormis, @EMARIANOMD, @PeterMerjavy, @amit_pawa, @LloydTurbitt, @womackjonathan

  • Correction notice This article has been corrected since it published Online First. The author's name, Rosemary MG Hogg, has been updated.

  • Collaborators Collaborators listed as main authors above.

  • Contributors Study concept, design and conduct: JH, TA, SW, MC. Systematic Review: JH, TA. Data collection: all authors. Manuscript preparation: JH, TA. Manuscript editing: JH, TA, SW, AJRM, KE-B, MC. Manuscript review and approval: all authors. Guarantor: JH.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests EA received grants from the Swiss Academy for Anaesthesia Research, Lausanne, Switzerland; B. Braun Medical AG, Sempach, Switzerland; and the Swiss National Science Foundation to support his clinical research. EA has also received an honorarium from B. Braun Medical AG Switzerland, Sintetica Ltd UK and MSD AG Switzerland. BF declares honoraria from B. Braun, Sintetica, Brain Therapeutics and Hospitality Medovate. ERM chairs the American Society of Anaesthesiologists Committee on Regional Anesthesia and Acute Pain Medicine. He is a former director of the American Society of Regional Anesthesia and Pain Medicine (ASRA). TA, AG, NH, DFJ, AJRM, AP, MPS, LT, SW, JW are members of the Board of Regional Anaesthesia UK (RA-UK). KE-B declares honoraria from GE Healthcare, Ambu, Fisher and Paykel, Edwards Lifesciences. AJRM declares honoraria and/or research funding from Intelligent Ultrasound. PM is a board member of European Diploma in Regional Anaesthesia (EDRA) and declares honoraria from B. Braun Medical and Medovate. AP declares honoraria from GE Healthcare, Butterfly Net, Sintetica UK and Pacira. KR was the President of the British Association of Day Surgery.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.