Evidence map›Paper›PMID 28143397›Full record

ArticleBMC anesthesiology2017

Retrospective case-control non-inferiority analysis of intravenous lidocaine in a colorectal surgery enhanced recovery program.

Bhiken I Naik, Siny Tsang, Anne Knisely, Sandeep Yerra, Marcel E Durieux

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in BMC anesthesiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03824808 (A Prospective, Randomized, Double-Blinded, Placebo-Controlled Clinical Trial Evaluating the Use of Perioperative Intravenous Lidocaine Infusion to Decrease Pain Scores and Opioid Consumption After Robotic-Assisted Prostatectomy and Robotic-Assisted Partial Nephrectomy), which is not on this 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
1.7field-weighted citation impact, top 16% 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.

NCT03824808 phase4terminatednot on this mapstarted 2019, after this paper: background citation

A Prospective, Randomized, Double-Blinded, Placebo-Controlled Clinical Trial Evaluating the Use of Perioperative Intravenous Lidocaine Infusion to Decrease Pain Scores and Opioid Consumption After Robotic-Assisted Prostatectomy and Robotic-Assisted Partial Nephrectomy

TypeinterventionalSponsorUniversity of Missouri-ColumbiaRan2019 to 2020Enrolled21ConditionsKidney Cancer, Prostate CancerArmsLidocaine Hydrochloride 0.8% in Dextrose 5% Solution, 0.9% Sodium Chloride Injection
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
  6. Effect of Multimodal Analgesia on Opioid Use After Open Ventral Hernia Repair.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2017
    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

5 authors at 2 institutions in 1 country.

Bhiken I NaikDepartment of Anesthesiology, University of Virginia, Charlottesville, VA, USA. bin4n@virginia.edu.
Siny TsangDepartment of Epidemiology, Columbia University, New York, NY, USA.
Anne KniselyDepartment of Anesthesiology, University of Virginia, Charlottesville, VA, USA.
Sandeep YerraDepartment of Anesthesiology, University of Virginia, Charlottesville, VA, USA.
Marcel E DurieuxDepartment of Anesthesiology, University of Virginia, Charlottesville, VA, USA.
University of Virginia · USColumbia University · US

Funding

RESEARCH TRAINING PROGRAM IN PSYCHIATRIC EPIDEMIOLOGYT32MH013043 · NIMH · COLUMBIA UNIV NEW YORK MORNINGSIDE · PI Katherine M. Keyes · 1985 to 2026
$11.7M
NIMH NIH HHS T32 MH013043
6 · The paper itself

Abstract

backgroundEnhanced recovery after surgery (ERAS) programs typically utilizes multi-modal analgesia to reduce perioperative opioid consumption. Systemic lidocaine is used in several of these ERAS algorithms and has been shown to reduce opioid use after colorectal surgery. However it is unclear how much the other components of an ERAS protocol contribute to the final outcome. Using a noninferiority analysis we sought to assess the role of perioperative lidocaine in an ERAS program for colorectal surgery, using pain and opioid consumption as outcomes.

methodsWe conducted a retrospective review of patients who had received intravenous lidocaine perioperatively during colorectal surgery. We matched them with patients who were managed using a multi-component ERAS protocol, which included perioperative lidocaine. We tested a joint hypothesis of noninferiority of lidocaine infusion to ERAS protocol in postoperative pain scores and opioid consumption. We assigned a noninferiority margin of 1 point (on an 11-point numerical rating scale) difference in pain and a ratio [mean (lidocaine) / mean (ERAS)] of 1.2 in opioid consumption, respectively.

resultsFifty-two patients in the lidocaine group were matched with patients in the ERAS group. With regards to opioid consumption, in the overall [1.68 (1.43-1.98)] [odds ratio (95% confidence interval)] analysis and on postoperative day (POD) 1 [2.38 (1.74-3.31)] lidocaine alone was inferior to multi-modal analgesia. On POD 2 and beyond, although the mean odds ratio for opioid consumption was 1.43 [1.43 (1.17-1.73)], the lower limit extended beyond the pre-defined cut-off of 1.2, rendering the outcome inconclusive. For pain scores lidocaine is non-inferior to ERAS [-0.17 (-1.08-0.74)] on POD 2 and beyond. Pain scores on POD 1 and in the overall cohort were inconclusive based on the noninferiority analysis.

conclusionsThe addition of a multi-component ERAS protocol to intravenous lidocaine incrementally reduces opioid consumption, most evident on POD 1. For pain scores the data is inconclusive on POD 1, however on POD 2 and beyond lidocaine alone is non-inferior to an ERAS program with lidocaine. Opioid-related complications, including return of bowel function, were not different between the groups despite reduced opioid use in the ERAS group.

Indexed as

Digestive System Surgical ProceduresAnalgesia, Patient-ControlledAnalgesics, OpioidAnesthetics, LocalCase-Control StudiesEarly AmbulationFemaleHumansHydromorphoneInfusions, IntravenousIntraoperative PeriodLength of StayLidocaineMaleMiddle AgedPain MeasurementAnalgesics, OpioidAnesthetics, LocalHydromorphoneLidocaineColorectal SurgeryEnhanced Recovery After SurgeryLidocaineOpioid ConsumptionPain Scores

Identifiers

PMID28143397
PMCPMC5282801
OpenAlexW2585253774

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.