Evidence map›Paper›PMID 32142529›Full record

Trial reportPloS one2020

Continuous wound infiltration versus epidural analgesia for midline abdominal incisions - a randomized-controlled pilot trial (Painless-Pilot trial; DRKS Number: DRKS00008023).

Rosa Klotz, Svenja E Seide, Phillip Knebel, Pascal Probst, Thomas Bruckner, Johann Motsch, Alexander Hyhlik-Dürr, Dittmar Böckler, Jan Larmann, Markus K Diener and 3 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 21% 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

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

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

13 authors at 1 institution in 1 country.

Rosa KlotzDepartment of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Svenja E SeideInstitute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.ORCID 0000-0002-9113-7373
Phillip KnebelDepartment of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Pascal ProbstDepartment of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Thomas BrucknerInstitute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.ORCID 0000-0001-9342-3456
Johann MotschDepartment of Anaesthesiology, University Hospital Heidelberg, Heidelberg, Germany.
Alexander Hyhlik-DürrDepartment of Vascular and Endovascular Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Dittmar BöcklerDepartment of Vascular and Endovascular Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Jan LarmannDepartment of Anaesthesiology, University Hospital Heidelberg, Heidelberg, Germany.
Markus K DienerDepartment of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Markus A WeigandDepartment of Anaesthesiology, University Hospital Heidelberg, Heidelberg, Germany.
Markus W BüchlerDepartment of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Andre L MihaljevicDepartment of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.ORCID 0000-0003-1902-657X
Heidelberg University · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo test the feasibility of a randomized controlled study design comparing epidural analgesia (EDA) with continuous wound infiltration (CWI) in respect to postoperative complications and mobility to design a future multicentre randomized controlled trial. DESIGN, SETTING,

participantsCWI has been developed to address drawbacks of EDA. Previous studies have established the equivalent analgesic potential of CWI compared to EDA. This is a single centre, non-blinded pilot randomized controlled trial at a tertiary surgical centre. Patients undergoing elective non-colorectal surgery via a midline laparotomy were randomized to EDA or CWI. Endpoints included recruitment, feasibility of assessing postoperative mobility with a pedometer and morbidity. No primary endpoint was defined and all analyses were explorative.

interventionsCWI with local anaesthetics (experimental group) vs. thoracic EDA (control).

resultsOf 846 patients screened within 14 months, 71 were randomized and 62 (31 per group) included in the intention-to-treat analysis. Mobility was assessed in 44 of 62 patients and revealed no differences within the first 3 postoperative days. Overall morbidity did not differ between the two groups (measured via the comprehensive complication index). Median pain scores at rest were comparable between the two groups, while EDA was superior in pain treatment during movement on the first, but not on the second and third postoperative day. Duration of preoperative induction of anaesthesia was shorter with CWI than with EDA. Of 17 serious adverse events, 3 were potentially related to EDA, while none was related to CWI.

conclusionThis trial confirmed the feasibility of a randomized trial design to compare CWI and EDA regarding morbidity. Improvements in the education and training of team members are necessary to improve recruitment.

trial registrationDRKS00008023.

Indexed as

Abdominal InjuriesAnalgesia, EpiduralAnesthesia, LocalAnesthetics, LocalElective Surgical ProceduresFemaleHumansLaparotomyMaleMiddle AgedPain ManagementPain MeasurementPilot ProjectsPostoperative ComplicationsPostoperative PainPostoperative PeriodAnesthetics, Local

Identifiers

PMID32142529
PMCPMC7059935
OpenAlexW3010034129

What OpenQuestion holds

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LicenceCC BY
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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.