Evidence map›Paper›PMID 31260468›Full record

Trial reportPloS one2019

Epidural morphine improves postoperative analgesia in patients after total knee arthroplasty: A randomized controlled trial.

Zhao-Ting Meng, Fan Cui, Xue-Ying Li, Dong-Xin Wang

3 registry-linked trialsOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.1field-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.

NCT03203967 nacompletednot on this map

Effect of Low-dose Epidural Morphine Combined With Single-injection Femoral Nerve Block on Postoperative Analgesia in Patients After Total Knee Arthroplasty

TypeinterventionalSponsorPeking University First HospitalRan2017 to 2018Enrolled110ConditionsAdult Patients, Total Knee Arthroplasty, Epidural Analgesia, Femoral Nerve BlockArmsEpidural morphine, Epidural placebo, Single femoral nerve block, Intravenous morphine analgesia
NCT04642651 phase4completednot on this mapstarted 2020, after this paper: background citation

Impacts of Dexmedetomidine as an Adjuvant for Femoral Nerve Block on Functional Recovery in Aged Patients After Total Knee Arthroplasty: a Randomized, Double-blinded, Controlled Trial

TypeinterventionalSponsorPeking University First HospitalRan2020 to 2022Enrolled170ConditionsElderly, Total Knee Arthroplasty, Femoral Nerve Block, DexmedetomidineArmsDexmedetomidine, Placebo
NCT04791059 phase4completednot on this mapstarted 2021, after this paper: background citation

Low-dose S-ketamine and Dexmedetomidine in Combination With Opioids for Patient-controlled Analgesia After Scoliosis Correction Surgery: a Randomized, Double-blind, Placebo-controlled Trial

TypeinterventionalSponsorPeking University First HospitalRan2021 to 2022Enrolled200ConditionsScoliosis Correction, Postoperative Analgesia, S-ketamine, DexmedetomidineArmsS-ketamine, Dexmedetomidine, Sufentanil
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 10 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. 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

4 authors at 1 institution in 1 country.

Zhao-Ting MengDepartment of Anesthesiology and Critical Care Medicine, Peking University First Hospital, Beijing, China.
Fan CuiDepartment of Anesthesiology and Critical Care Medicine, Peking University First Hospital, Beijing, China.
Xue-Ying LiDepartment of Biostatistics, Peking University First Hospital, Beijing, China.
Dong-Xin WangDepartment of Anesthesiology and Critical Care Medicine, Peking University First Hospital, Beijing, China.ORCID 0000-0002-3205-1836
Peking University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients after total knee arthroplasty (TKA) often develop moderate to severe pain. This study compared the analgesic effect of low-dose epidural morphine vs. a comparable saline injection in patients following TKA surgery.

methodsThis randomized, double-blinded, and placebo-controlled trial was conducted in a tertiary hospital in Beijing between July 1, 2017 and May 30, 2018. One hundred and ten patients following TKA under combined spinal-epidural anesthesia were randomized to receive either epidural morphine (2 mg diluted to 5 ml normal saline, the epidural morphine group) or placebo (5 ml normal saline, the placebo group). For all patients, single-injection femoral nerve block was performed, and a supplementary patient-controlled intravenous analgesia pump was provided. The severity of pain was assessed with the numerical rating scale (NRS, an 11-point scale where 0 = no pain and 10 = the worst pain) at 6, 12, 24, 36, and 48 hours after surgery. The primary endpoint was moderate to severe pain (NRS pain score ≥4) within 48 hours after surgery.

resultsThe percentage with moderate to severe pain within 48 hours was lower in the epidural morphine group than in the placebo group (58.2% [32/55] with epidural morphine vs. 76.4% [42/55] with placebo; OR 0.43, 95% CI 0.19-0.98; p = 0.042). Furthermore, the cumulative morphine consumption within 48 hours was lower (18.4±6.1 mg vs. 22.4±7.3 mg; p = 0.002) whereas the mental component summary score of 30-day quality of life was higher (63.8±2.9 vs. 61.9±4.2; p = 0.008) in the epidural morphine group than in the placebo group.

conclusionsFor patients following TKA, the addition of epidural morphine to single-injection femoral nerve block improves the quality of analgesia within 48 hours, without increasing adverse events.

trial registrationClinicalTrials.gov NCT03203967.

Indexed as

Analgesia, EpiduralAgedAged, 80 and overAnalgesia, Patient-ControlledArthroplasty, Replacement, KneeDouble-Blind MethodFemaleFemoral NerveHumansMaleMiddle AgedMorphineNerve BlockPain MeasurementPostoperative PainQuality of LifeMorphine

Identifiers

PMID31260468
PMCPMC6602200
OpenAlexW2953964312

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.