Evidence map›Paper›PMID 30088162›Full record

Trial reportGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2019

A randomized controlled trial of postoperative intravenous acetaminophen plus thoracic epidural analgesia vs. thoracic epidural analgesia alone after gastrectomy for gastric cancer.

Jun Kinoshita, Sachio Fushida, Masahide Kaji, Katsunobu Oyama, Daisuke Fujimoto, Yasuo Hirono, Tomoya Tsukada, Takashi Fujimura, Shigekazu Ohyama, Kazuhisa Yabushita and 4 more

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
1.4field-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

12 citing papers in PubMed, 21 citations in OpenAlex.

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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

14 authors at 8 institutions in 1 country.

Jun KinoshitaDepartment of Gastroenterological Surgery, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
Sachio FushidaDepartment of Gastroenterological Surgery, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641, Japan. fushida@staff.kanazawa-u.ac.jp.
Masahide KajiDepartment of Surgery, Toyama Prefectural Central Hospital, Toyama, Japan.
Katsunobu OyamaDepartment of Gastroenterological Surgery, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
Daisuke FujimotoFirst Department of Surgery, Fukui University Hospital, Fukui, Japan.
Yasuo HironoFirst Department of Surgery, Fukui University Hospital, Fukui, Japan.
Tomoya TsukadaDepartment of Surgery, Toyama Prefectural Central Hospital, Toyama, Japan.
Takashi FujimuraDepartment of Surgery, Toyama City Hospital, Toyama, Japan.
Shigekazu OhyamaDepartment of Surgery, National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan.
Kazuhisa YabushitaDepartment of Surgery, Takaoka City Hospital, Takaoka, Japan.
Naotaka KadoyaDepartment of Surgery, Toyama Rosai Hospital, Uozu, Japan.
Koji NishijimaDepartment of Surgery, Japanese Red Cross Kanazawa Hospital, Kanazawa, Japan.
Tetsuo OhtaDepartment of Gastroenterological Surgery, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
Digestive Disease Support Organization Study Group
Kanazawa University Hospital · JPToyama Prefectural Central Hospital · JPUniversity of Fukui Hospital · JPJapanese Red Cross Kanazawa Hospital · JPKanazawa Medical Center · JPKouseiren Takaoka Hospital · JPToyama City Hospital · JPToyama Rosai Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcetaminophen is used in multimodal therapy for postoperative pain management. However, the additional effects of acetaminophen in combination with thoracic epidural analgesia (TEA) are not well understood. This prospective, multicenter randomized study was conducted to evaluate the efficacy of routine intravenous (i.v.) acetaminophen in combination with TEA for the management of postoperative pain in gastric cancer surgery.

methodsA total of 120 patients who underwent distal gastrectomy were randomly assigned in a 1:1 ratio to receive i.v. acetaminophen every 6 h and TEA during the first 3 postoperative days (acetaminophen group) or TEA alone (control group). The primary endpoint was the sum of TEA rescue doses during the first 2 postoperative days.

resultsFinal analysis included 58 patients in the acetaminophen group and 56 patients in the control group. The median number of TEA rescue doses was significantly lower in the acetaminophen group compared with the control group (3.0 vs. 8.0, p = 0.013). The median area under the curve (AUC) of the pain scores at coughing was significantly less in the acetaminophen group compared with the control group (285 vs. 342, p = 0.046) without an increase in postoperative complications. TEA rescue doses and pain score AUCs were significantly reduced by acetaminophen in patients who underwent open gastrectomy (p = 0.037 and 0.045), whereas there was no significant difference between patients who underwent laparoscopic gastrectomy in the two groups.

conclusionsIn gastric cancer surgery patients, routine i.v. acetaminophen in combination with TEA provides superior postoperative pain management compared with TEA alone.

Indexed as

AcetaminophenAdministration, IntravenousAdultAgedAged, 80 and overAnalgesia, EpiduralFemaleGastrectomyHumansMaleMiddle AgedPain ManagementPostoperative PainStomach NeoplasmsThoracic VertebraeAcetaminophenAcetaminophenGastrectomyGastric cancerMultimodal analgesia

Identifiers

PMID30088162
PMCPMC6394709
OpenAlexW2887215439

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

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.