Evidence map›Paper›PMID 35803369›Full record

ArticleBrazilian journal of anesthesiology (Elsevier)

Regional analgesia and surgical site infections after colorectal surgery: a retrospective cohort analysis.

Gausan Ratna Bajracharya, Wael Ali Sakr Esa, Guangmei Mao, Steve Leung, Barak Cohen, Kamal Maheshwari, Hermann P Kessler, Emre Gorgun, Daniel I Sessler, Alparslan Turan

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Brazilian journal of anesthesiology (Elsevier). 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 38% 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

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 2 countries.

Gausan Ratna BajracharyaCleveland Clinic, Anesthesiology Institute, Department of Outcomes Research, Cleveland, USA; Cleveland Clinic, Anesthesiology Institute, Departments of General Anesthesia, Cleveland, USA.
Wael Ali Sakr EsaCleveland Clinic, Anesthesiology Institute, Department of Outcomes Research, Cleveland, USA; Cleveland Clinic, Anesthesiology Institute, Departments of General Anesthesia, Cleveland, USA.
Guangmei MaoCleveland Clinic, Anesthesiology Institute, Department of Outcomes Research, Cleveland, USA; Cleveland Clinic, Departments of Quantitative Health Science, Cleveland, USA.
Steve LeungCleveland Clinic, Anesthesiology Institute, Department of Outcomes Research, Cleveland, USA; Metro Health, Department of Radiology, Cleveland, USA.
Barak CohenCleveland Clinic, Anesthesiology Institute, Department of Outcomes Research, Cleveland, USA; Tel-Aviv University, Sackler Faculty of Medicine, Tel-Aviv Medical Center, Division of Anesthesia, Critical Care, and Pain Management, Tel-Aviv, Israel.
Kamal MaheshwariCleveland Clinic, Anesthesiology Institute, Department of Outcomes Research, Cleveland, USA; Cleveland Clinic, Anesthesiology Institute, Departments of General Anesthesia, Cleveland, USA.
Hermann P KesslerCleveland Clinic, Department of Colorectal Surgery, Cleveland, USA.
Emre GorgunCleveland Clinic, Department of Colorectal Surgery, Cleveland, USA.
Daniel I SesslerCleveland Clinic, Anesthesiology Institute, Department of Outcomes Research, Cleveland, USA.
Alparslan TuranCleveland Clinic, Anesthesiology Institute, Department of Outcomes Research, Cleveland, USA; Cleveland Clinic, Anesthesiology Institute, Departments of General Anesthesia, Cleveland, USA. Electronic address: turana@ccf.org.
Cleveland Clinic · USMetroHealth · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe effect of regional analgesia on perioperative infectious complications remains unknown. We therefore tested the hypothesis that a composite of serious infections after colorectal surgery is less common in patients with regional analgesia than in those given Intravenous Patient-Controlled Analgesia (IV-PCA) with opiates.

methodsPatients undergoing elective colorectal surgery lasting one hour or more under general anesthesia at the Cleveland Clinic Main Campus between 2009 and 2015 were included in this retrospective analysis. Exposures were defined as regional postoperative analgesia with epidurals or Transversus Abdominis Plane blocks (TAP); or IV-PCA with opiates only. The outcome was defined as a composite of in-hospital serious infections, including intraabdominal abscess, pelvic abscess, deep or organ-space Surgical Site Infection (SSI), clostridium difficile, pneumonia, or sepsis. Logistic regression model adjusted for the imbalanced potential confounding factors among the subset of matched surgeries was used to report the odds ratios along with 95% confidence limits. The significance criterion was p < 0.05.

resultsA total of 7811 patients met inclusion and exclusion criteria of which we successfully matched 681 regional anesthesia patients to 2862 IV-PCA only patients based on propensity scores derived from potential confounding factors. There were 82 (12%) in-hospital postoperative serious infections in the regional analgesia group vs. 285 (10%) in IV-PCA patients. Regional analgesia was not significantly associated with serious infection (odds ratio: 1.14; 95% Confidence Interval 0.87‒1.49; p-value = 0.339) after adjusting for surgical duration and volume of intraoperative crystalloids.

conclusionRegional analgesia should not be selected as postoperative analgesic technique to reduce infections.

Indexed as

Colorectal SurgeryOpiate AlkaloidsAbscessAnalgesia, Patient-ControlledAnalgesics, OpioidHumansPostoperative PainRetrospective StudiesSurgical Wound InfectionAnalgesics, OpioidOpiate AlkaloidsAnalgesia, patient-controlledColorectal surgeryOpiate alkaloidsRegional analgesiaSepsisSurgical wound infection

Identifiers

PMID35803369
PMCPMC9801205
OpenAlexW4284678011

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.