Evidence map›Paper›PMID 33554296›Full record

ArticleWorld journal of surgery2021

General Versus Neuraxial Anesthesia for Appendectomy: A Multicenter International Study.

Mohamad El Moheb, Kelsey Han, Kerry Breen, Majed El Hechi, Zhenyi Jia, Ava Mokhtari, Napaporn Kongkaewpaisan, Manasnun Kongwibulwut, Gabriel Rodriguez, Camilo Ortega and 14 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in World journal of surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 33% 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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. 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

24 authors at 15 institutions in 7 countries.

Mohamad El MohebDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, 165 Cambridge Street, Suite 810, Boston, MA, 02114, USA.
Kelsey HanDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, 165 Cambridge Street, Suite 810, Boston, MA, 02114, USA.
Kerry BreenDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, 165 Cambridge Street, Suite 810, Boston, MA, 02114, USA.
Majed El HechiDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, 165 Cambridge Street, Suite 810, Boston, MA, 02114, USA.
Zhenyi JiaDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, 165 Cambridge Street, Suite 810, Boston, MA, 02114, USA.
Ava MokhtariDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, 165 Cambridge Street, Suite 810, Boston, MA, 02114, USA.
Napaporn KongkaewpaisanDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, 165 Cambridge Street, Suite 810, Boston, MA, 02114, USA.
Manasnun KongwibulwutDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, 165 Cambridge Street, Suite 810, Boston, MA, 02114, USA.
Gabriel RodriguezDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, 165 Cambridge Street, Suite 810, Boston, MA, 02114, USA.
Camilo OrtegaHospital Departamental Villavicencio, Villavicencio, Colombia.
Huanlong QinDepartment of General Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
Jun YangDepartment of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.
Renyuan GaoDepartment of General Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
Zhiguo WangDepartment of Colorectal Surgery, Changzheng Hospital, Navy Medical University, Shanghai, People's Republic of China.
Zhiguang GaoDepartment of Emergency Surgery, Shanghai East Hospital of Tongji University, Shanghai, People's Republic of China.
Supparerk PrichayudhDepartment of Surgery, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Gwendolyn M van der WildenDepartment of Surgery, Alrijne Hospital, Leiden University Medical Center, Leiden, The Netherlands.
Stephanie SantinDepartment of Surgery, Hospital Brasil Rede D´Or, São Paulo, SP, Brazil.
Marcelo A F RibeiroDepartment of Surgery, Post-Graduation Program, Catholic University of São Paulo PUCSP-Sorocaba, Hospital Servidor Publico Estadual IAMSPE, Hospital Moriah, São Paulo, SP, Brazil.
Napakadol NoppakunsomboomDivision of Acute Care and Ambulatory Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Joseph V SakranDivision of Acute Care Surgery, Emergency General Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Bellal JosephDepartment of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA.
Ramzi AlamiDepartment of Surgery, American University of Beirut, Beirut, Lebanon.
Haytham M A KaafaraniDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, 165 Cambridge Street, Suite 810, Boston, MA, 02114, USA. hkaafarani@mgh.harvard.edu.
Harvard University · USMassachusetts General Hospital · USShanghai Tenth People's Hospital · CNAmerican University of Beirut · LBCorporación Universitaria del Meta · COJohns Hopkins University · USKing Chulalongkorn Memorial Hospital · THLeiden University Medical Center · NLMahidol University · THShanghai Changzheng Hospital · CNShanghai East Hospital · CNShanghai Sixth People's Hospital · CNSiriraj Hospital · THUniversidade de São Paulo · BRUniversity of Arizona · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn resource-limited countries, open appendectomy is still performed under general anesthesia (GA) or neuraxial anesthesia (NA). We sought to compare the postoperative outcomes of appendectomy under NA versus GA.

methodsWe conducted a post hoc analysis of the International Patterns of Opioid Prescribing (iPOP) multicenter study. All patients ≥ 16 years-old who underwent an open appendectomy between October 2016 and March 2017 in one of the 14 participating hospitals were included. Patients were stratified into two groups: NA-defined as spinal or epidural-and GA. All-cause morbidity, hospital length of stay (LOS), and pain severity were assessed using univariate analysis followed by multivariable logistic regression adjusting for the following preoperative characteristics: age, gender, body mass index (BMI), smoking, history of opioid use, emergency status, and country.

resultsA total of 655 patients were included, 353 of which were in the NA group and 302 in the GA group. The countries operating under NA were Colombia (39%), Thailand (31%), China (23%), and Brazil (7%). Overall, NA patients were younger (mean age (SD): 34.5 (14.4) vs. 40.7 (17.9), p-value < 0.001) and had a lower BMI (mean (SD): 23.5 (3.8) vs. 24.3 (5.2), p-value = 0.040) than GA patients. On multivariable analysis, NA was independently associated with less postoperative complications (OR, 95% CI: 0.30 [0.10-0.94]) and shorter hospital LOS (LOS > 3 days, OR, 95% CI: 0.47 [0.32-0.68]) compared to GA. There was no difference in postoperative pain severity between the two techniques.

conclusionsOpen appendectomy performed under NA is associated with improved outcomes compared to that performed under GA. Further randomized controlled studies should examine the safety and value of NA in lower abdominal surgery.

Indexed as

Analgesics, OpioidAppendectomyAdolescentAnesthesia, GeneralHumansLength of StayPostoperative ComplicationsPractice Patterns, Physicians'Retrospective StudiesAnalgesics, Opioid

Identifiers

PMID33554296
OpenAlexW3127942242

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Registered trials

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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.