Evidence map›Paper›PMID 32072229›Full record

ArticleWorld journal of urology2020

The association between N-methylnaltrexone, a peripherally acting mu-opioid receptor antagonist, and clinical outcomes in patients undergoing robotic-assisted radical cystectomy.

Andrew T Lenis, Vishnukamal Golla, Patrick M Lec, David C Johnson, Izak Faiena, Carol Lee, Siamak Rahman, Karim Chamie

Abstract read
PubMed Publisher
In one paragraph

Article in World journal of urology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 24% 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

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Article
  3. Peripherally Acting μ-Opioid Receptor Antagonists in the Management of Postoperative Ileus: a Clinical Review.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021
    Review
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 1 institution in 1 country.

Andrew T LenisDepartment of Urology, David Geffen School of Medicine At UCLA, 300 Stein Plaza, Suite 348, Los Angeles, CA, 90095, USA.ORCID http://orcid.org/0000-0001-9413-7793
Vishnukamal GollaDepartment of Urology, David Geffen School of Medicine At UCLA, 300 Stein Plaza, Suite 348, Los Angeles, CA, 90095, USA.
Patrick M LecDepartment of Urology, David Geffen School of Medicine At UCLA, 300 Stein Plaza, Suite 348, Los Angeles, CA, 90095, USA.
David C JohnsonDepartment of Urology, David Geffen School of Medicine At UCLA, 300 Stein Plaza, Suite 348, Los Angeles, CA, 90095, USA.
Izak FaienaDepartment of Urology, David Geffen School of Medicine At UCLA, 300 Stein Plaza, Suite 348, Los Angeles, CA, 90095, USA.
Carol LeeDepartment of Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Siamak RahmanDepartment of Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Karim ChamieDepartment of Urology, David Geffen School of Medicine At UCLA, 300 Stein Plaza, Suite 348, Los Angeles, CA, 90095, USA. kchamie@mednet.ucla.edu.
University of California, Los Angeles · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess the impact of N-methylnaltrexone, a peripherally acting mu-opioid receptor antagonist, on the post-operative recovery of patients undergoing robotic-assisted radical cystectomy for bladder cancer.

methodsWe retrospectively reviewed patients undergoing robotic-assisted radical cystectomy by a single surgeon (KC) prior to (control group) and after (treatment group) the routine use of N-methylnaltrexone. Kaplan-Meier curves and the log-rank test were used to quantify time to flatus, bowel movement, and discharge. Daily mean opioid use, daily pain assessment rating, and episodes of severe pain (7-10/10) were compared. Gastrointestinal-related complications, including ileus, emesis, and/or need for post-op nasogastric tube placement, and 30-day readmissions were also compared between groups. Charge capture data were compared between groups to analyze cost impact.

results29 patients each in the control and treatment group met inclusion criteria. Patients receiving N-methylnaltrexone had reduced length of stay compared with no N-methylnaltrexone (median 4 vs. 7 days, p < 0.01). Time to flatus and bowel movement, however, were similar. In a multivariable analysis controlling for possible confounders, however, the improvement in length of stay associated with N-methylnaltrexone use did not reach statistical significance (p = 0.11). Episodes of severe pain and composite gastrointestinal-related complications were reduced in the N-methylnaltrexone group (44.8% vs. 10.3%, p < 0.01). The reduction in length of stay was associated with approximately $10,500 in cost savings per patient.

conclusionsIn this study, N-methylnaltrexone was associated with reduced length of stay, fewer episodes of severe pain, and reduced costs. These results provide the impetus for further study.

Indexed as

Robotic Surgical ProceduresAgedCystectomyFemaleHumansMaleMiddle AgedNaltrexoneNarcotic AntagonistsPostoperative ComplicationsPostoperative PeriodQuaternary Ammonium CompoundsRetrospective StudiesTreatment OutcomeUrinary Bladder NeoplasmsmethylnaltrexoneNaltrexoneNarcotic AntagonistsQuaternary Ammonium CompoundsBladder cancerEnhanced recovery pathwayN-MethylnaltrexonePeripherally acting mu-opioid receptor antagonistRadical cystectomy

Identifiers

PMID32072229
OpenAlexW3007198482

What OpenQuestion holds

Textmetadata
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.