Evidence map›Paper›PMID 35044493›Full record

ArticleJournal of anesthesia2022

Feasibility of continuous epidural analgesia in patients with failed back surgery syndrome and spinal stenosis.

Vincent J Heck, Bastian Himpe, Paul Kessler, Asem Almajali, Tobias Prasse, Sven Schmidt, Michael Rauschmann

Open access · hybridAbstract read
In one paragraph

Article in Journal of anesthesia, 2022. 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
0.9field-weighted citation impact, top 29% 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, 4 citations in OpenAlex.

  1. Article
  2. Severity of spinal degeneration does not affect the pain reduction under continuous epidural analgesia.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023
    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

7 authors at 3 institutions in 2 countries.

Vincent J HeckOrthopedic University Hospital Friedrichsheim, University Hospital Frankfurt, Marienburgstrasse 2, 60528, Frankfurt am Main, Germany. vincent.heck@uk-koeln.de.ORCID 0000-0002-2541-6032
Bastian HimpeOrthopedic University Hospital Friedrichsheim, University Hospital Frankfurt, Marienburgstrasse 2, 60528, Frankfurt am Main, Germany.
Paul KesslerOrthopedic University Hospital Friedrichsheim, University Hospital Frankfurt, Marienburgstrasse 2, 60528, Frankfurt am Main, Germany.
Asem AlmajaliKing Hussein Medical Center, King Abdullah II St 230, Amman, 11733, Jordan.
Tobias PrasseFaculty of Medicine and University Hospital Cologne, Department of Orthopedics and Trauma Surgery, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Sven SchmidtOrthopedic University Hospital Friedrichsheim, University Hospital Frankfurt, Marienburgstrasse 2, 60528, Frankfurt am Main, Germany.
Michael RauschmannOrthopedic University Hospital Friedrichsheim, University Hospital Frankfurt, Marienburgstrasse 2, 60528, Frankfurt am Main, Germany.
Goethe University Frankfurt · DEKing Hussein Medical Center · JOUniversity of Cologne · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of this study was to outline the feasibility of continuous epidural analgesia in the treatment of failed back surgery syndrome (FBSS) or spinal stenosis.

methodsWe queried our prospective collected institutional database to include all consecutive patients, who underwent continuous epidural analgesia with accompanying intensive physiotherapeutic exercise within a timeframe of 4 years. Patients suffered from FBSS or spinal stenosis; protocolled continuous epidural analgesia was planned for 4 days within the framework of an inpatient multimodal pain therapy concept. The instillation technique of the epidural catheter, the capability to attend in accompanying physiotherapy, and the peri-interventional complications were evaluated.

results153 patients with an average age of 57.4 years (± 11.9) were enrolled in this study. 105 patients suffered from FBSS and 48 patients had spinal stenosis. Overall, 148 patients (96.7%) reported the pain reduction and were able to perform daily intensified physiotherapeutic exercise. There were no serious adverse events, neither infection nor bleeding, no cardiopulmonary complication or permanent neurological deficits. The most common side effect was neurological impairment, such as numbness, dysesthesia, or weakness of the lower limbs with complete regression after flow rate adjustment. Patients with FBSS were more likely to develop dysesthesia (p = 0.007).

conclusionsContinuous epidural analgesia is feasible in patients with FBSS or spinal stenosis. This treatment enables extensive physiotherapeutic treatment even in patients with severe pain conditions and can be considered as an alternative to epidural injections. An increased complication rate in comparison to short-term perioperative or perinatal application was not observed.

Indexed as

Analgesia, EpiduralFailed Back Surgery SyndromeSpinal StenosisFeasibility StudiesHumansMiddle AgedProspective StudiesEpidural analgesiaEpidural blockEpidural catheterFailed back surgerySpinal stenosis

Identifiers

PMID35044493
PMCPMC8967747
OpenAlexW4205519552

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.