Evidence map›Paper›PMID 33218672›Full record

SynthesisBritish journal of anaesthesia2021

Reducing the dose of neuromuscular blocking agents with adjuncts: a systematic review and meta-analysis.

Valentin Weber, Tom E F Abbott, Gareth L Ackland

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of anaesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
1.0field-weighted citation impact, top 23% 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

11 citing papers in PubMed, 10 citations in OpenAlex.

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  4. Effect ofDrug design, development and therapy · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Valentin WeberQueen Mary University of London, Barts and the London School of Medicine and Dentistry, London, UK.
Tom E F AbbottQueen Mary University of London, Barts and the London School of Medicine and Dentistry, London, UK; William Harvey Research Institute, Queen Mary University of London, London, UK.
Gareth L AcklandQueen Mary University of London, Barts and the London School of Medicine and Dentistry, London, UK; William Harvey Research Institute, Queen Mary University of London, London, UK. Electronic address: g.ackland@qmul.ac.uk.
Queen Mary University of London · GBWilliam Harvey Research Institute · GB

Funding

Department of Health NIHR300097
6 · The paper itself

Abstract

backgroundAcute global shortages of neuromuscular blocking agents (NMBA) threaten to impact adversely on perioperative and critical care. The use of pharmacological adjuncts may reduce NMBA dose. However, the magnitude of any putative effects remains unclear.

methodsWe conducted a systematic review and meta-analysis of RCTs. We searched Medline, Embase, Web of Science, and Cochrane Database (1970-2020) for RCTs comparing use of pharmacological adjuncts for NMBAs. We excluded RCTs not reporting perioperative NMBA dose. The primary outcome was total NMBA dose used to achieve a clinically acceptable depth of neuromuscular block. We assessed the quality of evidence using the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) criteria. Data are presented as the standardised mean difference (SMD); I

resultsFrom 3082 records, the full texts of 159 trials were retrieved. Thirty-one perioperative RCTs met the inclusion criteria for meta-analysis (n=1962). No studies were conducted in critically ill patients. Reduction in NMBA dose was associated with use of magnesium (SMD: -1.10 [-1.44 to -0.76], P<0.001; I

conclusionsMagnesium, dexmedetomidine, and clonidine may confer a clinically relevant sparing effect on the required dose of neuromuscular block ing drugs in the perioperative setting. SYSTEMATIC REVIEW REGISTRATION: PROSPERO: CRD42020183969.

Indexed as

Adjuvants, PharmaceuticClonidineDexmedetomidineDose-Response Relationship, DrugDrug SynergismHumansMagnesiumNeuromuscular BlockadeNeuromuscular Blocking AgentsPerioperative CareAdjuvants, PharmaceuticClonidineDexmedetomidineMagnesiumNeuromuscular Blocking Agentscalcium channel blockersdexamethasonedexmedetomidinelidocainemagnesiummechanical ventilationneuromuscular block

Identifiers

PMID33218672
PMCPMC8014939
OpenAlexW3103151328

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.