Observational studyHPB : the official journal of the International Hepato Pancreato Biliary Association2014
A prospective cohort study of intrathecal versus epidural analgesia for patients undergoing hepatic resection.
Observational study in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02647047 (Spinal Analgesia Versus Epidural Analgesia in Minor Laparotomic Liver Surgery in an Enhanced Recovery Programme), which is not on this map. Cited by 12 papers, 1 of them a synthesis 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.
Spinal Analgesia Versus Epidural Analgesia in Minor Laparotomic Liver Surgery in an Enhanced Recovery Programme: A Randomized Controlled Trial
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations.World journal of surgery · 2016Pooled it
- A Comparison of Intrathecal and Intravenous Morphine for Analgesia After Hepatectomy: A Randomized Controlled Trial.World journal of surgery · 2020Trial
- Postoperative analgesia for upper gastrointestinal surgery: a retrospective cohort analysis.Perioperative medicine (London, England) · 2023Article
- Postoperative Analgesia after Open Liver Surgery: Systematic Review of Clinical Evidence.Journal of clinical medicine · 2021Review
- A Literature Review of Intrathecal Morphine Analgesia in Patients Undergoing Major Open Hepato-Pancreatic-Biliary (HPB) Surgery.Anesthesiology and pain medicine · 2019Review
- Enhanced recovery after surgery in liver resection: current concepts and controversies.Korean journal of anesthesiology · 2019Review
- Article
- Comparison of Single-Shot Intrathecal Morphine Injection and Continuous Epidural Bupivacaine for Post-Operative Analgaesia after Elective Abdominal Hysterectomy.The Malaysian journal of medical sciences : MJMS · 2017Article
- Nonstrict and individual enhanced recovery after surgery (ERAS) in partial hepatectomy.SpringerPlus · 2016Article
- Cardiopulmonary exercise testing for predicting postoperative morbidity in patients undergoing hepatic resection surgery.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2015Article
- Unveiling the superior analgesic: Thoracic epidural versus intrathecal morphine in open live donor hepatectomy - A randomized controlled trial.Journal of anaesthesiology, clinical pharmacologyArticle
- Effect of different doses of intrathecal morphine on postoperative fentanyl consumption in open live donor hepatectomy - A double-blind, randomized controlled trial.Journal of anaesthesiology, clinical pharmacologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this prospective observational study was to compare peri/post-operative outcomes of thoracic epidural analgesia (TEA) versus intrathecal morphine and fentanyl patient-controlled analgesia (ITM+fPCA) for patients undergoing a hepatic resection (HR).
methodPatients undergoing elective, one-stage, open HR for benign and malignant liver lesions, receiving central neuraxial block as part of the anaesthetic, in a high-volume hepato-pancreato-biliary unit, were included in the study. The primary outcome measure was post-operative length of stay (LoS).
resultsA total of 73 patients (36 TEA and 37 ITM+fPCA) were included in the study. The median (IQR) post-operative LoS was 13 (11-15) and 11 (9-13) days in the TEA and ITM+fPCA groups, respectively (P = 0.011). There was significantly lower median intra-operative central venous pressure (P < 0.001) and blood loss (P = 0.017) in the TEA group, and a significant reduction in the time until mobilization (P < 0.001), post-operative intra-venous fluid/vasopressor requirement (P < 0.001/P = 0.004) in the ITM+fPCA group. Pain scores were lower at a clinically significant level 12 h post-operatively in the TEA group (P < 0.001); otherwise there were no differences out to day five. There were no differences in quality of recovery or postoperative morbidity/mortality between the two groups.
conclusionITM+fPCA provides acceptable post-operative outcomes for HR, but may also increase the incidence of intra-operative blood loss in comparison to TEA.
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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.