Evidence map›Paper›PMID 32516508›Full record

ArticleThe Laryngoscope2021

ERAS for Head and Neck Tissue Transfer Reduces Opioid Usage, Peak Pain Scores, and Blood Utilization.

Bhavishya S Clark, Mark Swanson, William Widjaja, Brian Cameron, Valerie Yu, Ksenia Ershova, Franklin M Wu, Erik B Vanstrum, Ruben Ulloa, Andrew Heng and 6 more

Open access · greenAbstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Laryngoscope, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
3.9field-weighted citation impact, top 6% 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, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.

  1. Unveiling Prescribing Patterns: A Systematic Review of Chronic Opioid Prescriptions After Head and Neck Cancer Surgeries.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2025
    Pooled it
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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

16 authors at 2 institutions in 1 country.

Bhavishya S ClarkDepartment of Otolaryngology - Head and Neck Surgery, Keck School of Medicine of USC, Los Angeles, California, U.S.A.ORCID 0000-0003-3003-5741
Mark SwansonDepartment of Otolaryngology - Head and Neck Surgery, Keck School of Medicine of USC, Los Angeles, California, U.S.A.ORCID 0000-0002-6140-0935
William WidjajaDepartment of Anesthesiology, Keck School of Medicine of USC, Los Angeles, California, U.S.A.
Brian CameronUSC Keck School of Medicine, Los Angeles, California, U.S.A.ORCID 0000-0001-7003-1484
Valerie YuDepartment of Anesthesiology, Keck School of Medicine of USC, Los Angeles, California, U.S.A.
Ksenia ErshovaDepartment of Anesthesiology, Keck School of Medicine of USC, Los Angeles, California, U.S.A.
Franklin M WuUSC Keck School of Medicine, Los Angeles, California, U.S.A.
Erik B VanstrumUSC Keck School of Medicine, Los Angeles, California, U.S.A.
Ruben UlloaUSC Keck School of Medicine, Los Angeles, California, U.S.A.
Andrew HengUSC Keck School of Medicine, Los Angeles, California, U.S.A.
Margaret NurimbaUSC Keck School of Medicine, Los Angeles, California, U.S.A.
Niels KokotDepartment of Otolaryngology - Head and Neck Surgery, Keck School of Medicine of USC, Los Angeles, California, U.S.A.ORCID 0000-0001-7388-6373
Amit KochharDepartment of Otolaryngology - Head and Neck Surgery, Keck School of Medicine of USC, Los Angeles, California, U.S.A.
Uttam K SinhaDepartment of Otolaryngology - Head and Neck Surgery, Keck School of Medicine of USC, Los Angeles, California, U.S.A.
M P KimDepartment of Anesthesiology, Keck School of Medicine of USC, Los Angeles, California, U.S.A.
Shane DickersonDepartment of Anesthesiology, Mount Sinai Hospital, New York, New York, U.S.A.
Keck Hospital of USC · USMount Sinai Hospital · US

Funding

Southern California Clinical and Translational Science InstituteUL1TR001855 · NCATS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Thomas A Buchanan, Michele D. Kipke · 2016 to 2026
$81.3M
Southern California Clinical and Translational Science InstituteUL1TR000130 · NCATS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI BUCHANAN, THOMAS A · 2012 to 2015
$36.0M
NCATS NIH HHS UL1 TR000130NCATS NIH HHS UL1 TR001855
6 · The paper itself

Abstract

objectivesWe implement a novel enhanced recovery after surgery (ERAS) protocol with pre-operative non-opioid loading, total intravenous anesthesia, multimodal peri-operative analgesia, and restricted red blood cell (pRBC) transfusions. 1) Compare differences in mean postoperative peak pain scores, opioid usage, and pRBC transfusions. 2) Examine changes in overall length of stay (LOS), intensive care unit LOS, complications, and 30-day readmissions.

methodsRetrospective cohort study comparing 132 ERAS vs. 66 non-ERAS patients after HNC tissue transfer reconstruction. Data was collected in a double-blind fashion by two teams.

resultsMean postoperative peak pain scores were lower in the ERAS group up to postoperative day (POD) 2. POD0: 4.6 ± 3.6 vs. 6.5 ± 3.5; P = .004) (POD1: 5.2 ± 3.5 vs. 7.3 ± 2.3; P = .002) (POD2: 4.1 ± 3.5 vs. 6.6 ± 2.8; P = .000). Opioid utilization, converted into morphine milligram equivalents, was decreased in the ERAS group (POD0: 6.0 ± 9.8 vs. 10.3 ± 10.8; P = .010) (POD1: 14.1 ± 22.1 vs. 34.2 ± 23.2; P = .000) (POD2: 11.4 ± 19.7 vs. 37.6 ± 31.7; P = .000) (POD3: 13.7 ± 20.5 vs. 37.9 ± 42.3; P = .000) (POD4: 11.7 ± 17.9 vs. 36.2 ± 39.2; P = .000) (POD5: 10.3 ± 17.9 vs. 35.4 ± 45.6; P = .000). Mean pRBC transfusion rate was lower in ERAS patients (2.1 vs. 3.1 units, P = .017). There were no differences between ERAS and non-ERAS patients in hospital LOS, ICU LOS, complication rates, and 30-day readmissions.

conclusionOur ERAS pathway reduced postoperative pain, opioid usage, and pRBC transfusions after HNC reconstruction. These benefits were obtained without an increase in hospital or ICU LOS, complications, or readmission rates. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:E792-E799, 2021.

Indexed as

Enhanced Recovery After SurgeryAgedAnalgesiaAnalgesics, OpioidBlood TransfusionDouble-Blind MethodFemaleHeadHumansLength of StayMaleMiddle AgedNeckOtorhinolaryngologic Surgical ProceduresPain ManagementPain MeasurementAnalgesics, OpioidEnhanced recovery after surgeryERASfree tissue transferhead and neck cancerrestricted blood transfusiontotal intravenous anesthesia

Identifiers

PMID32516508
PMCPMC8559523
OpenAlexW3033497449

What OpenQuestion holds

Textmetadata
LicenceTDM
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.