Evidence map›Paper›PMID 33977193›Full record

ArticlePediatric quality & safety

Impact of Eliminating Local Anesthesia on Immediate Postoperative Analgesia in Pediatric Ambulatory Adenotonsillectomy.

Kelsey A Loy, Austin S Lam, Amber M Franz, Lynn D Martin, Scott C Manning, Henry C Ou, Jonathan A Perkins, Sanjay R Parikh, Daniel K-W Low, John P Dahl

Open access · diamondAbstract read
In one paragraph

Article in Pediatric quality & safety. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
1.3field-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

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Perioperative clinical practice recommendations for pediatric tonsillectomy: a systematic review.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024
    Pooled it
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.

Kelsey A LoyDepartment of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Wash.
Austin S LamDepartment of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Wash.
Amber M FranzDepartment of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Wash.
Lynn D MartinDepartment of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Wash.
Scott C ManningDepartment of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Wash.
Henry C OuDepartment of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Wash.
Jonathan A PerkinsDepartment of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Wash.
Sanjay R ParikhDepartment of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Wash.
Daniel K-W LowDepartment of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Wash.
John P DahlDepartment of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Wash.
University of Washington · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Our goal was to standardize intraoperative analgesic regimens for pediatric ambulatory tonsillectomy by eliminating local anesthetic use and to determine its impact on postoperative pain measures, while controlling for other factors.

methodsWe assembled a quality improvement team at an ambulatory surgery center. They introduced a standardized anesthetic protocol, involving American Society of Anesthesiologists Classification 1 and 2 patients undergoing adenotonsillectomy. Local anesthesia elimination was the project's single intervention. We collected pre-intervention data (79 cases) from July 5 to September 17, 2019 and post-intervention data (59 cases) from September 25 to December 17, 2019. The intervention requested that surgeons eliminate the use of local anesthetics. The following outcomes measures were evaluated using statistical process control charts and Shewhart's theory of variation: (1) maximum pain score in the post-anesthesia care unit, (2) total post-anesthesia care unit minutes, and (3) postoperative opioid rescue rate.

resultsNo special cause variation signal was detected in any of the measures following the intervention.

conclusionsOur data suggest that eliminating intraoperative local anesthetic use does not worsen postoperative pain control at our facility. The intervention eliminated the added expenses and possible risks associated with local anesthetic use. This series is unique in its standardization of anesthetic regimen in a high-volume ambulatory surgery center with the exception of local anesthesia practices. The study results may impact the standardized clinical protocol for pediatric ambulatory adenotonsillectomy at our institution and may hold relevance for other centers.

Identifiers

PMID33977193
PMCPMC8104218
OpenAlexW3161883102

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.