ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2020
A Standardized Multimodal Analgesia Protocol Reduces Perioperative Opioid Use in Minimally Invasive Colorectal Surgery.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03723447 (A Prospective Randomized Trial of Transversus Abdominis Plane), which is not on this map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
A Prospective Randomized Trial of Transversus Abdominis Plane (TAP) INtraoperative Block With Bupivacaine/Dexamethasone aGainst Liposomal Bupivacaine (Exparel®): the TINGLE Trial
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Comparison of the effects of dexmedetomidine and lidocaine on postoperative analgesia and recovery characteristics: a meta-analysis of randomized controlled trials.Systematic reviews · 2026Pooled it
- The impact of sleep interventions combined with enhanced nutritional support on sleep quality, nutritional status, pain management, psychological well-being, and quality of life in postoperative colon cancer patients.Journal of cancer research and clinical oncology · 2025Trial
- The efficacy of preemptive multimodal analgesia in elderly patients undergoing laparoscopic colorectal surgery: a randomized controlled trial.Scientific reports · 2024Trial
- Utilization and evolving prescribing practice of opioid and non-opioid analgesics in patients undergoing lymphadenectomy for cutaneous malignancy.Journal of surgical oncology · 2022Trial
- Factors associated with prolonged use of newly prescribed gabapentinoids in older adults undergoing colorectal surgery.Perioperative medicine (London, England) · 2026Article
- Venlafaxine as Monotherapy and in Combination Regimens in Acute Rodent Nociception Experimental Models: A Review.International journal of molecular sciences · 2026Review
- Risk factors for postoperative gastrointestinal dysfunction in adult patients undergoing short laparoscopic surgery: a prospective exploratory observational study.BMC anesthesiology · 2026Observational
- Article
- Personalized Multimodal and Opioid-Sparing Analgesia for Postoperative Pain Management: Enhancing Recovery and Addressing the Post-Discharge Gap.Journal of pain research · 2026Review
- Comparison of Opioid Consumption During Paediatric Anaesthesia with and Without a Mandatory Protocol: A Retrospective Cohort Study.Journal of clinical medicine · 2025Article
- Article
- Optimizing postoperative recovery in colorectal cancer patients through integrated psychological and nutritional interventions.Journal of cancer survivorship : research and practice · 2025Article
- Postoperative pain management using high-dose oral acetaminophen for enhanced recovery after colorectal cancer surgery.Surgery today · 2025Article
- Postoperative Multimodal Analgesia Strategy for Enhanced Recovery After Surgery in Elderly Colorectal Cancer Patients.Pain and therapy · 2024Review
- Two-stage laparoscopic transversus abdominis plane block as an equivalent alternative to thoracic epidural anaesthesia in bowel resection-an explorative cohort study.International journal of colorectal disease · 2024Article
- Process, structural, and outcome quality indicators to support perioperative opioid stewardship: a rapid review.Perioperative medicine (London, England) · 2023Article
- Comparative analysis of opioid use between robotic and open pancreatoduodenectomy.Journal of hepato-biliary-pancreatic sciences · 2023Article
- Positive Patient Postoperative Outcomes with Pharmacotherapy: A Narrative Review including Perioperative-Specialty Pharmacist Interviews.Journal of clinical medicine · 2022Article
- Transversus Abdominis Plane Block Reduces Intraoperative Opioid Consumption in Patients Undergoing Periacetabular Osteotomy.Journal of clinical medicine · 2022Article
- Nonopioid perioperative analgesia in head and neck cancer surgery: A systematic review.World journal of otorhinolaryngology - head and neck surgery · 2022Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMultimodal analgesia protocols are becoming a common part of enhanced recovery pathways after colorectal surgery. However, few protocols include a robust intraoperative component in addition to pre-operative and post-operative analgesics.
methodA prospective cohort study was performed in an urban teaching hospital in patients undergoing minimally invasive colorectal surgery before and after implementation of a multimodal analgesia protocol consisting of pre-operative (gabapentin, acetaminophen, celecoxib), intraoperative (lidocaine and magnesium infusions, ketorolac, transversus abdominis plane block), and post-operative (gabapentin, acetaminophen, celecoxib) opioid-sparing elements. The main outcome measure was use of morphine equivalents in the first 24-h post-operative period.
resultsThe study cohort (n = 71) included 41 patients before and 30 patients after implementation of a multimodal analgesia protocol. Mean age of the entire study cohort was 47 ± 19.7 years and 46% were male. Patients undergoing surgery post-multimodal analgesia vs. pre-multimodal analgesia had significantly lower use of IV morphine equivalents in first 24-h post-operative period (5.8 ± 6.4 mg vs. 22.8 ± 21.3 mg; p = 0.005) and first 48-h post-operative period (7.6 ± 9.4 mg vs. 42 ± 52.9 mg; p = 0.0008). This reduction in IV morphine equivalent use post-multimodal analgesia was coupled with improved pain scores in the post-operative period. Post-operative hospital length of stay, post-operative ileus, and overall complications were not significantly different between groups.
conclusionsMultimodal analgesia incorporating pre-operative, intraoperative, and post-operative opioid-sparing agents is an effective method for reducing perioperative opioid utilization and pain after minimally invasive colorectal surgery.
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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.