Evidence map›Paper›PMID 33451596›Full record

Trial reportAmerican journal of obstetrics & gynecology MFM2021

Lidocaine patches for postcesarean pain control in obese women: a pilot randomized controlled trial.

Kathleen M Antony, Jacquelyn H Adams, Laura Jacques, Scott Hetzel, Richard J Chappell, Sarah E Gnadt, Amye J Tevaarwerk

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in American journal of obstetrics & gynecology MFM, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
1.2field-weighted citation impact, top 19% 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

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
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

7 authors at 3 institutions in 1 country.

Kathleen M AntonyDivision of Maternal-Fetal Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Electronic address: kantony@wisc.edu.
Jacquelyn H AdamsDivision of Maternal-Fetal Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Laura JacquesDivision of Academic Specialists in Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Scott HetzelDepartment of Obstetrics and Gynecology, and Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Richard J ChappellDepartment of Obstetrics and Gynecology, and Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Sarah E GnadtDepartment of Pharmacy, UnityPoint Health - Meriter Hospital, Madison, WI.
Amye J TevaarwerkDivision of Hematology and Oncology, Department of Medicine, Wisconsin Institutes for Medical Research, University of Wisconsin School of Medicine and Public Health, Madison, WI; University of Wisconsin Carbone Cancer Center, Madison, WI.
University of Wisconsin–Madison · USMeriter Hospital · USUniversity of Wisconsin Carbone Cancer Center · US

Funding

University of Wisconsin Institute for Clinical and Translational ResearchUL1TR002373 · NCATS · UNIVERSITY OF WISCONSIN-MADISON · PI ELIZABETH S BURNSIDE, Allan R. Brasier · 2017 to 2026
$75.9M
NCATS NIH HHS UL1 TR002373
6 · The paper itself

Abstract

backgroundObesity increases the risk of opioid-related morbidity. Lidocaine patches have been shown to reduce postoperative pain after noncesarean surgeries.

objectiveThis study aimed to determine whether the application of lidocaine patches around the cesarean incision in women with obesity reduces the total dose of opioids administered in the first 24 hours after cesarean delivery. STUDY

designThis was a pilot single-blind randomized controlled trial of 61 women with obesity undergoing cesarean delivery at a community tertiary referral hospital staffed by academic physicians. After cesarean delivery, the allocated patches (either 5% lidocaine patches or placebo patches) were applied superior and lateral to the incision dressing and remained in place for 12 hours. The average cumulative opioid dose received within the first 24 hours after cesarean delivery was measured in morphine milligram equivalents. We also assessed pain and patient satisfaction. A sample size of 60 (30 per group) was determined to be adequate to inform a future appropriately powered randomized controlled trial. The primary outcome of morphine milligram equivalents was compared using the Student t test, and pain scores were compared using the Wilcoxon rank sum test.

resultsOf the 146 women screened between February 2019 and September 2019, 61 consented and were analyzed: 30 women were allocated to lidocaine patch and 31 were allocated to placebo (hydrocolloid patch). Women who were allocated to the lidocaine patch used an average of 87.0 (standard deviation, 35.8) morphine milligram equivalents of opioids in the first 24 hours compared with an average of 83.9 (standard deviation, 27.5) morphine milligram equivalents among women who were allocated to the placebo patch (P=.702). Women who were allocated to the lidocaine vs placebo patches reported median pain scores of 3.0 (interquartile range, 2.1-4.9) and 3.5 (interquartile range, 2.5-5.0), respectively (P=.217). The time to the first dose of opioids, total number of opioid doses, and total morphine milligram equivalents in 48 hours and for the entire hospital stay did not differ. Patient satisfaction with both patches was high and not statistically different.

conclusionThis pilot suggests that 5% lidocaine patches applied superior and lateral to the cesarean incision are not effective at reducing the average total dose of morphine milligram equivalents administered in the first 24 hours after cesarean delivery among women with obesity, and they did not seem to improve median pain scores. An appropriately powered randomized trial would not be expected to demonstrate reduction in opioid use or pain.

Indexed as

LidocainePostoperative PainFemaleHumansObesityPain MeasurementPilot ProjectsPregnancySingle-Blind MethodLidocainecesareanlocal anesthetic patchesmultimodal analgesiaobesityobstetricsopioid-sparing analgesiapainpostcesarean painpostoperativepregnancy

Identifiers

PMID33451596
PMCPMC9516415
OpenAlexW3108063760

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.