Evidence map›Paper›PMID 33900978›Full record

ArticleInternational journal of spine surgery2021

Multimodal Analgesic Management for Cervical Spine Surgery in the Ambulatory Setting.

Nathaniel W Jenkins, James M Parrish, Michael T Nolte, Caroline N Jadczak, Shruthi Mohan, Cara E Geoghegan, Nadia M Hrynewycz, Jeffrey Podnar, Asokumar Buvanendran, Kern Singh

Open access · diamondAbstract read
In one paragraph

Article in International journal of spine 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
1.9field-weighted citation impact, top 15% 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, 11 citations in OpenAlex.

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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

10 authors at 1 institution in 1 country.

Nathaniel W JenkinsDepartment of Orthopaedic Surgery, , Rush University Medical Center, Chicago, Illinois.
James M ParrishDepartment of Orthopaedic Surgery, , Rush University Medical Center, Chicago, Illinois.
Michael T NolteDepartment of Orthopaedic Surgery, , Rush University Medical Center, Chicago, Illinois.
Caroline N JadczakDepartment of Orthopaedic Surgery, , Rush University Medical Center, Chicago, Illinois.
Shruthi MohanDepartment of Orthopaedic Surgery, , Rush University Medical Center, Chicago, Illinois.
Cara E GeogheganDepartment of Orthopaedic Surgery, , Rush University Medical Center, Chicago, Illinois.
Nadia M HrynewyczDepartment of Orthopaedic Surgery, , Rush University Medical Center, Chicago, Illinois.
Jeffrey PodnarDepartment of Anesthesiology, Midwest Anesthesia Partners LLC, Park Ridge, Illinois.
Asokumar BuvanendranDepartment of Anesthesiology, Rush University Medical Center, Chicago, Illinois.
Kern SinghDepartment of Orthopaedic Surgery, , Rush University Medical Center, Chicago, Illinois.
Rush University Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatient selection and analgesic techniques, such as the multimodal analgesic (MMA) protocol, aid in ambulatory surgical center (ASC) cervical spine surgery. The purpose of this case series is to characterize patients undergoing anterior cervical discectomy and fusion (ACDF) and total cervical disc replacement (CDR) in an ASC with an enhanced MMA protocol.

methodsA prospectively maintained registry was retrospectively reviewed for cervical surgeries between May 2013 and August 2019. Inclusion criteria included ASC patients who underwent single-level or multilevel CDR or ACDF using an MMA protocol. Baseline, intraoperative, and postoperative characteristics were recorded, including length of stay, visual analog scale pain scores, neck disability index, complications, and narcotics administered.

resultsA total of 178 patients met inclusion criteria with 125 single-level, 52 two-level, and 1 three-level procedure. Of those patients, 127 underwent ACDF and 51 underwent CDR. The longest procedure was 95 minutes and the mean length of stay was 6.1 hours, with 2 patients requiring hospital admission. All other patients were discharged within 10 hours. One of the admitted patients experienced a postoperative seizure that was later determined to be secondary to drug use and serotonin syndrome. The second patient developed an anterior cervical hematoma 5 hours postoperatively, which was immediately evacuated. The patient was admitted for observation and discharged the next day.

conclusionIn our study, patients experienced considerable improvement in disability scores, with a low likelihood of postoperative complications. A safe and effective MMA protocol may help facilitate anterior cervical surgery in the outpatient setting. LEVEL OF EVIDENCE: 3. CLINICAL RELEVANCE: Transitioning anterior cervical discectomy and fusions to the ASC requires an appropriate MMA protocol. Our findings reveal that an enhanced MMA protocol will help improve disability scores while keeping the likelihood of postoperative complications low. This supports the ASC setting for cervical spine procedures in appropriate patient populations.

Indexed as

anterior cervical discectomy and fusioncervical disc replacementcervical spine surgerymultimodal analgesia

Identifiers

PMID33900978
PMCPMC8059397
OpenAlexW3151114247

What OpenQuestion holds

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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.