Evidence map›Paper›PMID 35246743›Full record

Observational studySurgical endoscopy2022

The NOpioid Project: a prospective observational feasibility study examining the implementation of a non-narcotic post-operative pain control regimen.

Joseph DeVitis, Emily Flom, Tristan Cooper-Roth, Alan Davis, Laura Krech, Chelsea Fisk, Steffen Pounders, Douglas Kwazneski, Alistair Chapman, Carrie Valdez

Open access · bronzeAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Surgical endoscopy, 2022. 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
0.4field-weighted citation impact, top 39% 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, 2 citations in OpenAlex.

  1. 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

10 authors at 4 institutions in 1 country.

Joseph DeVitisTrauma Research Institute, Spectrum Health, Grand Rapids, USA.
Emily FlomDepartment of Surgery, Yale New Haven Hospital, New Haven, USA.
Tristan Cooper-RothDepartment of Surgery, Tucson Medical Center, Tucson, USA.
Alan DavisTrauma Research Institute, Spectrum Health, Grand Rapids, USA.
Laura KrechTrauma Research Institute, Spectrum Health, Grand Rapids, USA.
Chelsea FiskTrauma Research Institute, Spectrum Health, Grand Rapids, USA.
Steffen PoundersTrauma Research Institute, Spectrum Health, Grand Rapids, USA.
Douglas KwazneskiTrauma Research Institute, Spectrum Health, Grand Rapids, USA.
Alistair ChapmanTrauma Research Institute, Spectrum Health, Grand Rapids, USA.
Carrie ValdezDepartment of Surgery, The Ohio State University, 395 W. 12th Ave Rm 614A, Columbus, OH, 43210, USA. carrievaldezmd@gmail.com.ORCID http://orcid.org/0000-0002-7124-0584
Spectrum Health · USThe Ohio State University · USTucson Medical Center · USYale New Haven Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPost-operative prescription of opioids has fueled an increase in opioid-associated morbidity and mortality. Alternative post-operative pain control with non-opioid pharmaceuticals can help counteract this effect. We investigated a non-opioid pain management protocol following emergent laparoscopic appendectomy and laparoscopic cholecystectomy.

methodsOur tertiary referral center performed a prospective observational feasibility study of patients from October 2019 to 2020 who underwent emergent laparoscopic appendectomies and cholecystectomies. Patients aged 18-65 with no prior history of chronic pain or opioid abuse, no contraindications to taking acetaminophen and ibuprofen, and Glomerular Filtration Rate > 60 ml/min were included. Counseling was provided about non-narcotic pain control. Patients were not prescribed narcotics at discharge and were instead prescribed ibuprofen and acetaminophen. Patients were surveyed at their 2-week post-operative appointment to assess pain control and other patient-reported outcomes, including quality of life (QOL).

resultsFifty-one patients met the inclusion criteria and completed the postoperative survey. Thirty-two were female (63%), average age 38, and BMI 30.4. 30 (59%) underwent laparoscopic appendectomy for acute non-perforated appendicitis and 21 (41%) underwent laparoscopic cholecystectomy for acute cholecystitis or symptomatic cholelithiasis. 88% of patients felt satisfied or neutral with their post-operative pain control at discharge. After 2 weeks, 34 patients (66.7%) rated QOL as high, 17 (33.3%) rated QOL as moderate, and none rated QOL as poor. Fascial suture was not associated with poor outcomes. Anxiety, depression, alcohol use, and prior abdominal surgery were not associated with increased need for post-operative narcotics. There were no significant differences between appendectomy and cholecystectomy in satisfaction with pain control or QOL (p > 0.05).

conclusionPatients undergoing surgery have an increased risk of developing an opioid disorder. The NOpioid Project demonstrated a non-narcotic multimodal pain regimen can be effectively adopted in the post-operative period after an emergent laparoscopic appendectomy or emergent laparoscopic cholecystectomy.

Indexed as

Analgesics, Non-NarcoticAppendicitisAcetaminophenAdultAnalgesics, OpioidAppendectomyFeasibility StudiesFemaleHumansIbuprofenMaleNarcoticsPostoperative PainQuality of LifeAcetaminophenAnalgesics, Non-NarcoticAnalgesics, OpioidIbuprofenNarcoticsAcute care surgeryEmergent laparoscopic appendectomy/cholecystectomyNon-narcotic pain protocol after surgeryPatient-reported pain scoresQuality of life

Identifiers

PMID35246743
PMCPMC8896850
OpenAlexW4220739584

What OpenQuestion holds

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Read underepoch 390

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.