Evidence map›Paper›PMID 34015047›Full record

ArticlePloS one2021

Impact of paravertebral blocks on analgesic and non-analgesic outcomes after video-assisted thoracoscopic surgery: A propensity matched cohort study.

Yatish S Ranganath, Vendhan Ramanujam, Yoshiko Onodera, John Keech, Evgeny Arshava, Kalpaj R Parekh, Rakesh V Sondekoppam

Open access · goldAbstract read
In one paragraph

Article in PloS one, 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
0.2field-weighted citation impact, top 48% 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 citations in OpenAlex.

  1. Review
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 2 countries.

Yatish S RanganathDepartment of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States of America.ORCID 0000-0002-6106-4687
Vendhan RamanujamDepartment of Anesthesiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America.
Yoshiko OnoderaDepartment of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Asahikawa, Japan.ORCID 0000-0001-7061-4217
John KeechDepartment of Surgery - Cardiothoracic Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States of America.
Evgeny ArshavaDepartment of Surgery - Cardiothoracic Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States of America.
Kalpaj R ParekhDepartment of Surgery - Cardiothoracic Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States of America.
Rakesh V SondekoppamDepartment of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States of America.ORCID 0000-0003-1132-9066
University of Iowa · USAsahikawa Medical University · JPBrown University · US

Funding

Vector Core-Core 2P30DK054759 · NIDDK · UNIVERSITY OF IOWA · PI Amy Leanne Ryan · 1998 to 2026
$30.5M
NIDDK NIH HHS P30 DK054759
6 · The paper itself

Abstract

backgroundRegional analgesic techniques such as paravertebral blocks (PVBs) have been popularized for analgesia following video-assisted thoracoscopic surgery (VATS). In this single center retrospective propensity matched cohort of subjects, we investigate the impact of paravertebral blocks on the analgesic and non-analgesic outcomes.

methodsInstitutional database was queried to identify all patients undergoing VATS between January 2013 and July 2019 and these patients were divided into those who received paravertebral blocks in combination with general anesthesia (GA) [PVB group] and those who received GA without paravertebral blocks [GA group]. Propensity score matching based on common patient confounders were used to identify patients in each group. Primary outcomes of the study were average pain scores and opioid consumption in the first 24 hours. Secondary analgesic outcomes included pain scores and opioid requirements at other timepoints over the first 48 hours. Non analgesic outcomes were obtained from STS General Thoracic Surgery Database and included length of hospital stay, need for ICU admission, composite outcome of any complication during the hospital course and 30-day mortality. Exploratory analyses were conducted to investigate the impact of PVB on analgesia following different types of surgery and as to whether any other covariates had a greater influence on the included patient centered outcomes. MAIN

resultsAfter propensity score matching, a total of 520 patients (260 per group) were selected for the study out of 1095 patients. The opioid consumption in terms of oral morphine milligram equivalent (MME) [Median (IQR)] for the first 24 hours was significantly lower with the use of PVB [PVB group- 78.5 (96.75); GA group-127.0 (111.5); p<0.001] while the average pain scores in the first 24 hours did not differ significantly [PVB group-4.71 (2.28); GA group-4.85 (2.30); p = 0.70]. The length of hospital stay, opioid requirements at other timepoints, need for ICU admission in the immediate post-operative period and the composite outcome-'any complication' (35% vs 48%) were significantly lower with the use of PVB. Subgroup analysis showed a longer duration of benefit following major lung surgeries compared to others.

conclusionParavertebral blocks reduced the length of stay and opioid consumption up to 48 hours after VATS without significantly impacting pain scores.

Indexed as

AgedAnalgesiaAnalgesics, OpioidAnesthesia, GeneralCohort StudiesFemaleHumansMaleMiddle AgedNerve BlockPain ManagementPostoperative PainThoracic Surgery, Video-AssistedAnalgesics, Opioid

Identifiers

PMID34015047
PMCPMC8136840
OpenAlexW3161658204

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.