Evidence map›Paper›PMID 24913242›Full record

Trial reportObesity surgery2014

Does epidural morphine loading in addition to thoracic epidural analgesia benefit the postoperative management of morbidly obese patients undergoing open bariatric surgery? A pilot study.

Anastasia Zotou, Athina Siampalioti, Panagiota Tagari, Leonidas Paridis, Fotis Kalfarentzos, Kriton S Filos

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Obesity surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.

  1. Guideline
  2. Trial
  3. Article
  4. Review
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Anastasia ZotouDepartment of Anesthesiology and Critical Care Medicine, University Hospital of Patras, Rion, Patras, 26504, Greece, anzotou@hotmail.com.
Athina Siampalioti
Panagiota Tagari
Leonidas Paridis
Fotis Kalfarentzos
Kriton S Filos
General University Hospital of Patras · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInsufficient data exist regarding postoperative thoracic epidural analgesia for morbidly obese patients undergoing open bariatric surgery. This study evaluated the effectiveness of morphine loading in a postoperative thoracic epidural analgesic regimen of patient-controlled epidural analgesia (PCEA) with levobupivacaine combined with continuously administered epidural morphine in this patient group.

methodsIn this prospective randomized controlled trial, 48 superobese patients (body mass index of ≥ 50 kg/m(2)) undergoing open bariatric surgery were randomly allocated to three groups of 16 patients each. Postoperatively, all groups received a continuous epidural morphine infusion of 0.2 mg/h with 0.1 % levobupivacaine via PCEA. Group A did not receive intraoperative epidural morphine loading, while groups B and C received an intraoperative 1- and 2-mg morphine bolus, respectively. Levobupivacaine consumption via PCEA (primary outcome), pain scores at rest and on cough, the time to return of bowel function and ambulation, and arterial blood gas levels (secondary outcomes) were recorded.

resultsThe increase in perioperative morphine administration (groups B and C) led to a significantly prolonged return to normal bowel function and delayed ambulation (P<0.05 to 0.01, respectively), without an improvement in postoperative analgesia or a reduction in local anesthetic consumption. Although the prevalence of obstructive sleep apnea (OSA) was high in all groups, no respiratory depression was observed.

conclusionsThoracic PCEA with 0.1 % levobupivacaine combined with continuous epidural morphine administration of 0.2 mg/h without morphine loading is an effective postoperative analgesic regimen that provides adequate pain control, early ambulation, and early return of bowel function in superobese patients, particularly those with OSA.

Indexed as

AdultAnalgesia, EpiduralAnalgesia, Patient-ControlledAnalgesics, OpioidAnesthetics, LocalBariatric SurgeryBupivacaineFemaleHumansLevobupivacaineMaleMorphineObesity, MorbidPain MeasurementPilot ProjectsPostoperative PainAnalgesics, OpioidAnesthetics, LocalBupivacaineLevobupivacaineMorphine

Identifiers

PMID24913242
OpenAlexW1984358648

What OpenQuestion holds

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Registered trials

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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.