Evidence map›Paper›PMID 34852928›Full record

Trial reportBritish journal of anaesthesia2022

Patient-maintained versus anaesthetist-controlled propofol sedation during elective primary lower-limb arthroplasty performed under spinal anaesthesia: a randomised controlled trial.

David W Hewson, Frank Worcester, James Sprinks, Murray D Smith, Heather Buchanan, Philip Breedon, Jonathan G Hardman, Nigel M Bedforth

Open access · hybridAbstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in British journal of anaesthesia, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
0.7field-weighted citation impact, top 27% 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

6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. 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

8 authors at 4 institutions in 1 country.

David W HewsonDepartment of Anaesthesia and Critical Care Medicine, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK. Electronic address: david.hewson@nottingham.ac.uk.
Frank WorcesterMedical Engineering Design Research Group, Nottingham Trent University, Nottingham, UK.
James SprinksMedical Engineering Design Research Group, Nottingham Trent University, Nottingham, UK.
Murray D SmithCommunity and Health Research Unit, University of Lincoln, Lincoln, UK.
Heather BuchananDivision of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK.
Philip BreedonMedical Engineering Design Research Group, Nottingham Trent University, Nottingham, UK.
Jonathan G HardmanDepartment of Anaesthesia and Critical Care Medicine, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK; Anaesthesia & Critical Care Research Group, Injury, Inflammation and Recovery Sciences Unit, School of Medicine, University of Nottingham, Nottingham, UK.
Nigel M BedforthDepartment of Anaesthesia and Critical Care Medicine, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Nottingham Trent University · GBNottingham University Hospitals NHS Trust · GBUniversity of Lincoln · GBUniversity of Nottingham · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatient-maintained propofol TCI sedation (PMPS) allows patients to titrate their own target-controlled infusion (TCI) delivery of propofol sedation using a handheld button. The aim of this RCT was to compare PMPS with anaesthetist-controlled propofol TCI sedation (ACPS) in patients undergoing elective primary lower-limb arthroplasty surgery under spinal anaesthesia.

methodsIn this single-centre open-label investigator-led study, adult patients were randomly assigned to either PMPS or ACPS during their surgery. Both sedation regimes used Schnider effect-site TCI modelling. The primary outcome measure was infusion rate adjusted for weight (expressed as mg kg

resultsEighty patients (48 female) were randomised. Subjects using PMPS used 39.3% less propofol during the sedation period compared with subjects in group ACPS (1.56 [0.57] vs 2.57 [1.33] mg kg

conclusionsPatient-maintained propofol sedation during lower-limb arthroplasty under spinal anaesthesia results in reduced drug exposure and fewer episodes of sedation-related adverse events compared with anaesthetist-controlled propofol TCI sedation. To facilitate further investigation of this procedural sedation technique, PMPS-capable TCI infusion devices should be submitted for regulatory approval for clinical use. CLINICAL

trial registrationISRCTN29129799.

Indexed as

AgedAged, 80 and overAnesthesia, SpinalAnesthetistsArthroplastyFemaleHumansHypnotics and SedativesLower ExtremityMaleMiddle AgedPropofolHypnotics and SedativesPropofolanxiolytic agentsarthroplastyconscious sedationpatient satisfactionpropofolsedationtarget-controlled infusion

Identifiers

PMID34852928
PMCPMC8787772
OpenAlexW3213013796

What OpenQuestion holds

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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.