Evidence map›Paper›PMID 26209855›Full record

Trial reportBritish journal of anaesthesia2016

Neuraxial block and postoperative epidural analgesia: effects on outcomes in the POISE-2 trial†.

K Leslie, D McIlroy, J Kasza, A Forbes, A Kurz, J Khan, C S Meyhoff, R Allard, G Landoni, X Jara and 9 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in British journal of anaesthesia, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

12 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Observational
  4. Article
  5. Observational
  6. Article
  7. Article
  8. Review
  9. [Neuraxial anaesthesia and NOACs].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2017
    Review
  10. Article
  11. Article
  12. Article
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

19 authors.

K LeslieDepartment of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Australia Anaesthesia, Perioperative and Pain Medicine Unit Department of Pharmacology, University of Melbourne, Melbourne, Australia Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia kate.leslie@mh.org.au.
D McIlroyDepartment of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Australia.
J KaszaDepartment of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
A ForbesDepartment of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
A KurzDepartment of Outcomes Research, Cleveland Clinic, Cleveland, USA.
J KhanPopulation Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada Departments of Clinical Epidemiology Biostatistics, McMaster University, Hamilton, Canada Department of Anesthesiology, University of Toronto, Toronto, Canada.
C S MeyhoffDepartment of Anaesthesiology, Herlev Hospital and University of Copenhagen, Herlev, Denmark.
R AllardDepartment of Anesthesiology and Perioperative Medicine, Kingston General Hospital and Queen's University, Kingston, Canada.
G LandoniDepartment of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute and Vita-Salute University, Milan, Italy.
X JaraDepartment of Anesthesiology, Clinica Santa Maria and Universidad de Los Andes, Santiago, Chile.
G Lurati BuseDepartment of Anaesthesiology, Juravinski Hospital, Hamilton, Canada.
K CandiottiDepartment of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami, Miami, USA.
H-S LeeDepartment of Anesthesiology, Sultanah Aminah Hospital, Johor Bahru, Malaysia.
R GuptaDepartment of Medicine, Fortis Escorts Hospital, Jaipur, India.
T VanHelderDepartment of Anesthesia, Hamilton General Hospital, Hamilton, Canada.
W PurayilDepartment of Anaesthesia, Westfort Hi-tech Hospital, Thrissur, India.
S De HertDepartment of Anaesthesiology, Ghent University Hospital, Ghent, Belgium.
T TreschanDepartment of Anaesthesiology, Duesseldorf University Hospital, Duesseldorf, Germany.
P J DevereauxPopulation Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada Departments of Clinical Epidemiology Biostatistics, McMaster University, Hamilton, Canada Department of Medicine, McMaster University, Hamilton, Canada.

Funding

Canadian Institutes of Health Research
6 · The paper itself

Abstract

backgroundWe assessed associations between intraoperative neuraxial block and postoperative epidural analgesia, and a composite primary outcome of death or non-fatal myocardial infarction, at 30 days post-randomization in POISE-2 Trial subjects.

methods10 010 high-risk noncardiac surgical patients were randomized aspirin or placebo and clonidine or placebo. Neuraxial block was defined as intraoperative spinal anaesthesia, or thoracic or lumbar epidural anaesthesia. Postoperative epidural analgesia was defined as postoperative epidural local anaesthetic and/or opioid administration. We used logistic regression with weighting using estimated propensity scores.

resultsNeuraxial block was not associated with the primary outcome [7.5% vs 6.5%; odds ratio (OR), 0.89; 95% CI (confidence interval), 0.73-1.08; P=0.24], death (1.0% vs 1.4%; OR, 0.84; 95% CI, 0.53-1.35; P=0.48), myocardial infarction (6.9% vs 5.5%; OR, 0.91; 95% CI, 0.74-1.12; P=0.36) or stroke (0.3% vs 0.4%; OR, 1.05; 95% CI, 0.44-2.49; P=0.91). Neuraxial block was associated with less clinically important hypotension (39% vs 46%; OR, 0.90; 95% CI, 0.81-1.00; P=0.04). Postoperative epidural analgesia was not associated with the primary outcome (11.8% vs 6.2%; OR, 1.48; 95% CI, 0.89-2.48; P=0.13), death (1.3% vs 0.8%; OR, 0.84; 95% CI, 0.35-1.99; P=0.68], myocardial infarction (11.0% vs 5.7%; OR, 1.53; 95% CI, 0.90-2.61; P=0.11], stroke (0.4% vs 0.4%; OR, 0.65; 95% CI, 0.18-2.32; P=0.50] or clinically important hypotension (63% vs 36%; OR, 1.40; 95% CI, 0.95-2.09; P=0.09).

conclusionsNeuraxial block and postoperative epidural analgesia were not associated with adverse cardiovascular outcomes among POISE-2 subjects.

Indexed as

AgedAged, 80 and overAnalgesia, EpiduralFemaleHumansHypotensionMaleMiddle AgedMyocardial InfarctionNerve BlockPostoperative ComplicationsPostoperative PeriodSingle-Blind MethodStrokeanaesthesia, epiduralanaesthesia, spinaldeathmyocardial infarctionstroke

Identifiers

PMID26209855
PMCPMC4681616

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.