Evidence map›Paper›PMID 28419639›Full record

ArticlePaediatric anaesthesia2017

Differences in intraoperative hemodynamics between spinal and general anesthesia in infants undergoing pyloromyotomy.

Caleb Ing, Lena S Sun, Alexander F Friend, Minjae Kim, Mitchell F Berman, William Paganelli, Guohua Li, Robert K Williams

Open access · bronzeAbstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Paediatric anaesthesia, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 3 pooled it
1.4field-weighted citation impact, top 22% 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

7 citing papers in PubMed, 3 syntheses or guidelines pooled it, 31 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Article
  6. Observational
  7. 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

8 authors at 2 institutions in 1 country.

Caleb IngDepartment of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY, USA.ORCID http://orcid.org/0000-0001-5917-9234
Lena S SunDepartment of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Alexander F FriendDepartment of Anesthesiology, University of Vermont Medical Center, Burlington, VT, USA.
Minjae KimDepartment of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Mitchell F BermanDepartment of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
William PaganelliDepartment of Anesthesiology, University of Vermont Medical Center, Burlington, VT, USA.
Guohua LiDepartment of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Robert K WilliamsDepartment of Anesthesiology, University of Vermont Medical Center, Burlington, VT, USA.
Columbia University · USUniversity of Vermont Medical Center · US

Funding

Clinical and Translational Science AwardUL1TR000040 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GINSBERG, HENRY N · 2012 to 2015
$26.2M
Anesthesia Exposure and Risk of Behavioral or Developmental DisorderK08HS022941 · AHRQ · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI ING, CALEB · 2014 to 2018
$632k
AHRQ HHS K08 HS022941NCATS NIH HHS UL1 TR000040
6 · The paper itself

Abstract

backgroundHypotension and bradycardia are known side effects of spinal anesthesia in pregnant women undergoing cesarean section and adults undergoing other surgical procedures. Whether children experience similar hemodynamic changes is unclear.

aimsThe purpose of this study is to evaluate hemodynamic effects of spinal anesthesia compared to general anesthesia in a cohort of healthy infants.

methodsThe University of Vermont Medical Center almost exclusively used spinal anesthesia for infant pyloromyotomy surgery between 2008 and 2013, while Columbia University Medical Center relied on general anesthesia. The primary outcome assessed was the percentage change in intraoperative heart rate and blood pressure (systolic [SBP] and mean [MAP] blood pressure) from baseline. Analysis was performed using t-tests for continuous variables, followed by linear regression to account for differences in demographic and clinical covariates.

resultsThe study sample consisted of 51 infants with spinal anesthesia at the University of Vermont and 52 infants with general anesthesia at Columbia University. The decrease from baseline for mean intraoperative SBP was -8.2 ± 16.8% for spinal anesthesia and -24.2 ± 17.2% for general anesthesia (difference between means: 16.2% [95% confidence interval (CI), 9.5-22.9]), while the decrease from baseline for mean intraoperative MAP was -16.3 ± 19.9% for spinal anesthesia and -24.6 ± 19.3% for general anesthesia (difference between means: 8.4% [95% CI, 0.8-16]). Spinal anesthesia patients also had smaller drops in minimum intraoperative MAP and SBP. These blood pressure differences persisted even after adjusting for covariates. No differences in heart rate were seen between spinal and general anesthesia. DISCUSSION: Our findings show that spinal anesthesia performed in healthy infants undergoing pyloromyotomy results in reduced intraoperative blood pressure changes from baseline, significantly higher blood pressure readings, and no increased bradycardia compared to general anesthesia. Further research is needed to assess whether any clinical impact of these hemodynamic differences between spinal and general anesthesia exists.

Indexed as

Anesthesia, GeneralAnesthesia, SpinalBlood PressureCohort StudiesFemaleHeart RateHemodynamicsHumansInfantInfant, PrematureIntraoperative PeriodMalePyloromyotomyblood pressuregeneral anesthesiaheart ratehemodynamicsinfantlocal anesthetics

Identifiers

PMID28419639
PMCPMC5461197
OpenAlexW2606563272

What OpenQuestion holds

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Registered trials

None linked

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.