Evidence map›Paper›PMID 34979943›Full record

Trial reportBMC anesthesiology2022

Effect of general anesthesia with thoracic paravertebral block on postoperative delirium in elderly patients undergoing thoracoscopic lobectomy: a randomized-controlled trial.

Wei Wei, Xi Zheng, Yu Gu, Wenting Fu, Chunlin Tang, Yonghua Yao

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC anesthesiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 3 pooled it
6.7field-weighted citation impact, top 2% 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

24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 43 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

6 authors at 1 institution in 1 country.

Wei Wei *Department of anesthesiology, cancer hospital and institute of Guangzhou medical university, Guangzhuou, 510000, Guangdong, China.
Xi Zheng *Department of anesthesiology, cancer hospital and institute of Guangzhou medical university, Guangzhuou, 510000, Guangdong, China.
Yu GuDepartment of anesthesiology, cancer hospital and institute of Guangzhou medical university, Guangzhuou, 510000, Guangdong, China.
Wenting FuDepartment of anesthesiology, cancer hospital and institute of Guangzhou medical university, Guangzhuou, 510000, Guangdong, China.
Chunlin TangDepartment of anesthesiology, cancer hospital and institute of Guangzhou medical university, Guangzhuou, 510000, Guangdong, China.
Yonghua YaoDepartment of anesthesiology, cancer hospital and institute of Guangzhou medical university, Guangzhuou, 510000, Guangdong, China. 726832646@qq.com.
Guangzhou Medical University Cancer Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostoperative delirium (POD) is characterized by acute brain dysfunction, especially in elderly patients. Postoperative pain is an important factor in the development of delirium, and effective pain management can reduce the risk of POD. Thoracic paravertebral block (TPVB) can effectively relieve postoperative pain and inhibit the perioperative stress and inflammatory response. We investigated whether the combination of TPVB with general anesthesia reduced the occurrence of POD following thoracoscopic lobectomy.

methodsA total of 338 elderly patients, aged 65-80 years, who underwent elective surgery for video-assisted thoracoscopic lobectomy (VATS) were randomly assigned to either a patient-controlled intravenous analgesia group (PIA) or a patient-controlled paravertebral-block analgesia group (PBA). POD was evaluated using the 3-min diagnostic confusion assessment method (3D-CAM). The postoperative quality of recovery (QoR) was assessed with Chinese version of QoR-40 scale. Pain intensity was measured using the visual analog scale (VAS) score. Tumor necrosis factor-α (TNF-α) and neurofilament light (NFL) levels were determined using enzyme-linked immunosorbent assay (ELISA) kits.

resultsDelirium occurred in 47 (28%) of 168 cases in the PIA group and 28 (16.5%) of 170 cases in the PBA group (RR 1.7, p = 0.03). PBA was also associated with a higher rate of overall recovery quality at day 7 after surgery (27.1% vs. 17.3%, P = 0.013) compared with PIA. The incremental change in surgery-induced TNF-α and NFL was greater in the PIA group than PBA group (p < 0.05).

conclusionThoracic paravertebral block analgesia is associated with lower incidence of postoperative delirium, probably due to its anti-neuroinflammatory effects. Furthermore, as a component of multimodal analgesia, TPVB provides not only superior analgesic but also opioid-sparing effects.

trial registrationThe study was registered on the Chinese Clinical Trial Registry Center ( www.chictr.org.cn ; registration number: ChiCTR 2,000,033,238 ) on 25/05/2018.

Indexed as

AgedAged, 80 and overAnesthesia, GeneralChinaComorbidityDeliriumFemaleHumansLungLung NeoplasmsMaleNerve BlockPostoperative ComplicationsPostoperative PainThoracic Surgery, Video-AssistedPostoperative deliriumPostoperative quality of recoveryThoracic paravertebral blockVideo-assisted thoracoscopic lobectomy

Identifiers

PMID34979943
PMCPMC8722018
OpenAlexW4205593017

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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.