Trial reportEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2013
A comprehensive multimodal pain treatment reduces opioid consumption after multilevel spine surgery.
Trial report in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 7 registered trials, which are not on this map. Cited by 88 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pre-Emptive Analgesia in Ano-Rectal Surgery
Effects of Intra-Operative Ropivaciane Epidural Injection on Post-Operative Outcomes Following Elective Lumbar Fusion
A Prospective Randomized Double Blind Trial to Assess the Effect of a Single Preoperative Dose of Gabapentin on Postoperative Opioid Consumption in Patients Undergoing Rhinoplasty
Erector Spinae Plane Block in Lumbar Spinal Fusion : Double-blind, Randomized Controlled Trial.
Erector Spinae Plane Block in Lumbar Release Surgery : Double-blind, Randomized Controlled Trial
Effect of Perioperative Use of Dexmedetomidine-esketamine Combination on Incidence of Moderate-to-severe Pain After Spinal Surgery: a Randomized Controlled Trial
Effect of Perioperative Use of Dexmedetomidine-esketamine Combination on Incidence of Chronic Postsurgical Pain After Spinal Surgery: a Randomized Controlled Trial
Who cites it
88 citing papers in PubMed, 4 syntheses or guidelines pooled it, 257 citations in OpenAlex.
- Enhanced recovery after surgery (ERAS) in adolescent idiopathic scoliosis (AIS): a meta-analysis and systematic review.Spine deformity · 2021Pooled it
- Pathway for enhanced recovery after spinal surgery-a systematic review of evidence for use of individual components.BMC anesthesiology · 2021Pooled it
- Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis.The Cochrane database of systematic reviews · 2020Pooled it
- Dexmedetomidine as a sedative and analgesic adjuvant in spine surgery: a systematic review and meta-analysis of randomized controlled trials.European journal of clinical pharmacology · 2018Pooled it
- Surgical vs ultrasound-guided lumbar erector spinae plane block for pain management following lumbar spinal fusion surgery.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Trial
- Effects of Fu's Subcutaneous Needling on Postoperative Pain in Patients Receiving Surgery for Degenerative Lumbar Spinal Disorders: A Single-Blind, Randomized Controlled Trial.Journal of pain research · 2024Trial
- Comparison of the effect of melatonin, dexmedetomidine, and gabapentin on reduction of postoperative pain and anxiety following laminectomy: a randomized clinical trial.BMC anesthesiology · 2022Trial
- Dexmedetomidine combined with ropivacaine for erector spinae plane block after posterior lumbar spine surgery: a randomized controlled trial.BMC musculoskeletal disorders · 2022Trial
- Efficacy of erector spinae plane block on postoperative pain in patients undergoing lumbar spine surgery.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022Trial
- Preoperative pregabalin has no effect on intraoperative neurophysiological monitoring in adolescents undergoing posterior spinal fusion for spinal deformities: a double-blind, randomized, placebo-controlled clinical trial.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2018Trial
- Continuous wound infusion of ropivacaine for the control of pain after thoracolumbar spinal surgery: a randomized clinical trial.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2017Trial
- Does continuous wound infiltration enhance baseline intravenous multimodal analgesia after posterior spinal fusion surgery? A randomized, double-blinded, placebo-controlled study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2017Trial
- Effects of Topical Steroids on Postoperative Pain in Patients Undergoing Stand-Alone Lateral Lumbar Interbody Fusion.Cureus · 2026Article
- Article
- Evidence-based practice of enhanced recovery after surgery in spinal surgery: Comprehensive insights into perioperative care and outcome improvement.The Journal of international medical research · 2026Review
- Article
- Analgesic effects of bilateral ultrasound-guided erector spinae plane block versus patient controlled intravenous analgesia in correction surgery for idiopathic scoliosis: study protocol for a randomized controlled trial.Perioperative medicine (London, England) · 2025Article
- The Effect of Intravenous Parecoxib on Early Ambulation After Elective Lumbar Spinal Surgery: A Propensity Score Matching Analysis.Journal of clinical medicine · 2025Article
- Erector spinae plane block for postoperative analgesia in vertebral surgery: an umbrella review of systematic reviews and meta-analyses.The Korean journal of pain · 2025Article
- Article
28 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMajor spine surgery with multilevel instrumentation is followed by large amount of opioid consumption, significant pain and difficult mobilization in a population of predominantly chronic pain patients. This case-control study investigated if a standardized comprehensive pain and postoperative nausea and vomiting (PONV) treatment protocol would improve pain treatment in this population.
methodsA new regimen with acetaminophen, NSAIDs, gabapentin, S-ketamine, dexamethasone, ondansetron and epidural local anesthetic infusion or patient controlled analgesia with morphine, was introduced in a post-intervention group of 41 consecutive patients undergoing multilevel (median 10) instrumented spinal fusions and compared with 44 patients in a pre-intervention group.
resultsCompared to patients in the pre-intervention group, patients treated according to the new protocol consumed less opioid on postoperative day (POD) 1 (P = 0.024) and 2 (P = 0.048), they were mobilized earlier from bed (P = 0.003) and ambulation was earlier both with and without a walking frame (P = 0.027 and P = 0.027, respectively). Finally, patients following the new protocol experienced low intensities of nausea, sedation and dizziness on POD 1-6.
conclusionsIn this study of patients scheduled for multilevel spine surgery, it was demonstrated that compared to a historic group of patients receiving usual care, a comprehensive and standardized multimodal pain and PONV protocol significantly reduced opioid consumption, improved postoperative mobilization and presented concomitant low levels of nausea, sedation and dizziness.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.