Evidence map›Paper›PMID 33231842›Full record

ArticleDrugs - real world outcomes2021

Lessons from the Analysis of a Retrospective Cohort of Patients Who Underwent Large Open Abdominal Surgery Under Total Intravenous Opioid-Free Anesthesia.

Jean-Pierre Estebe, Mathieu Morel, Timothée Daouphars, Elric Ardant, Chloé Rousseau, Anaïs Drouet, Camille Bosquet, Karim Boudjema

Abstract read
In one paragraph

Article in Drugs - real world outcomes, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

8 authors.

Jean-Pierre EstebeDepartment of Anesthesiology, Intensive Care, and Pain Medicine, University Hospital of Rennes, Rue Henri Le Guilloux, 35033, Rennes Cedex 9, France. jean-pierre.estebe@chu-rennes.fr.ORCID http://orcid.org/0000-0003-3287-4477
Mathieu MorelDepartment of Anesthesiology, Intensive Care, and Pain Medicine, University Hospital of Rennes, Rue Henri Le Guilloux, 35033, Rennes Cedex 9, France.
Timothée DaoupharsDepartment of Anesthesiology, Intensive Care, and Pain Medicine, University Hospital of Rennes, Rue Henri Le Guilloux, 35033, Rennes Cedex 9, France.
Elric ArdantDepartment of Anesthesiology, Intensive Care, and Pain Medicine, University Hospital of Rennes, Rue Henri Le Guilloux, 35033, Rennes Cedex 9, France.
Chloé RousseauClinical Investigation Center (CIC-INSERM 1414), University Hospital of Rennes, Rue Henri Le Guilloux, 35033, Rennes Cedex 9, France.
Anaïs DrouetDepartment of Anesthesiology, Intensive Care, and Pain Medicine, University Hospital of Rennes, Rue Henri Le Guilloux, 35033, Rennes Cedex 9, France.
Camille BosquetDepartment of Anesthesiology, Intensive Care, and Pain Medicine, University Hospital of Rennes, Rue Henri Le Guilloux, 35033, Rennes Cedex 9, France.
Karim BoudjemaDepartment of Abdominal Surgery, University Hospital of Rennes, Rue Henri Le Guilloux, 35033, Rennes Cedex 9, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOpioid-free anesthesia (OFA) is a new method of anesthesia based on a paradigm shift. Under general anesthesia, the physiology and/or the pathophysiological variations clinically observed are more a reflection of a systemic reaction to the stress (surgical and anesthesia stresses) than a true reflection of pain.

objectiveTo report the results of a large monocenter, retrospective, non-interventional observational study of all consecutive patients who received a total intravenous (IV)-OFA protocol for the surgical management of major open abdominal and urological surgery. PATIENTS AND

methodsWe retrospectively extracted the anesthesia files of 311 consecutive patients (regional anesthesia excluded). No opioids were administered to any of these patients during the surgery. IV morphine administered in the recovery room was the primary endpoint of the study. The secondary endpoints included the amount of opioid required during the first two postoperative days, as well as the maximum pain intensity.

resultsOnly very small doses of IV morphine were administered. The mean total morphine titration was 2 mg (1.9 ± 2.9 mg), corresponding to control of the maximal level of pain to 2.1 ± 2.6 as evaluated with a numerical scale in the postoperative care unit. Similarly, we observed a very low level of morphine consumption during the first two postoperative days.

conclusionsThese results highlight the safety and the feasibility of our total IV-OFA protocol, thus confirming this new paradigm. Under general anesthesia, the cardiovascular and inflammatory response to the stress could be reliably managed through a multimodal approach without a need for opioids. In the postoperative period, very low doses of opioids were required.

Identifiers

PMID33231842
PMCPMC7984139

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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.