Evidence map›Paper›PMID 35101683›Full record

Observational studyThe Journal of surgical research2022

Association of Prehabilitation With Postoperative Opioid Use in Colorectal Surgery: An Observational Cohort Study.

Angela Lee, Elizabeth Shelton, Serena Bidwell, Kreeti Shankar, Kazuo Ando, Brice Gaudilliere, Andrew Shelton, Cindy Kin

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in The Journal of surgical research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
2.8field-weighted citation impact, top 10% 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

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Review
  6. Review
  7. 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 2 institutions in 1 country.

Angela LeeSchool of Medicine, Stanford University, Stanford, California.
Elizabeth SheltonDepartment of Surgery, Stanford University, Stanford, California.
Serena BidwellDepartment of Surgery, Stanford University, Stanford, California.
Kreeti ShankarDepartment of Surgery, Stanford University, Stanford, California.
Kazuo AndoDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California.
Brice GaudilliereDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California.
Andrew SheltonDepartment of Surgery, Stanford University, Stanford, California.
Cindy KinDepartment of Surgery, Stanford University, Stanford, California. Electronic address: cindykin@stanford.edu.
Stanford University · USStanford Medicine · US

Funding

Harnessing the human monocyte system to improve surgical recoveryR35GM137936 · NIGMS · STANFORD UNIVERSITY · PI GAUDILLIERE, BRICE · 2020 to 2024
$2.0M
NIGMS NIH HHS R35 GM137936
6 · The paper itself

Abstract

introductionPreoperative optimization programs have demonstrated positive effects on perioperative physical function and surgical outcomes. In nonsurgical populations, physical activity and healthy diet may reduce pain and pain medication requirement, but this has not been studied in surgical patients. Our aim was to determine whether a preoperative diet and exercise intervention affects postoperative pain and pain medication use.

methodsPatients undergoing abdominal colorectal surgery were invited to participate in a web-based patient engagement program. Those enrolling in the first and third time periods received information on the standard perioperative pathway (enhanced recovery after surgery [ERAS]). Those enrolling in the second time period also received reminders on nutrition and exercise (PREHAB + ERAS). The primary outcome was postoperative inpatient opioid use. The secondary outcomes were inpatient postoperative pain scores and nonopioid pain medication use.

resultsThe ERAS and PREHAB + ERAS groups were similar in demographic and operative characteristics. Subgroup analysis of patients who activated their accounts demonstrated that the two groups had similar average maximum daily pain scores, but the PREHAB + ERAS group (n = 158) used 15.9 fewer oral morphine equivalents per postoperative inpatient day than the ERAS group (n = 92), representing a 30% decrease (53 mg versus 37.1 mg, P = 0.04). The two groups used comparable amounts of acetaminophen, gabapentin, and ketorolac. Generalized linear models demonstrated that PREHAB + ERAS, minimally invasive surgery, and older age were associated with lower inpatient opioid use.

conclusionsAccess to a web-based preoperative diet and exercise program may reduce inpatient opioid use after major elective colorectal surgery. Further studies are necessary to determine whether the degree of adherence to nutrition and physical activity recommendations has a dose-dependent effect on opioid use.

Indexed as

Colorectal SurgeryOpioid-Related DisordersAnalgesics, OpioidCohort StudiesHumansPostoperative PainPreoperative ExerciseRetrospective StudiesAnalgesics, OpioidPatient engagementPostoperative opioidsPostoperative painPrehabilitationWeb-based patient platform

Identifiers

PMID35101683
PMCPMC9090308
OpenAlexW4210545726

What OpenQuestion holds

Textmetadata
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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.