Evidence map›Paper›PMID 35981781›Full record

ArticleBMJ open2022

Intrathecal diamorphine for perioperative analgesia during colorectal surgery: a cross-sectional survey of current UK practice.

Joseph Alderman, Amit Sharma, Jaimin Patel, Fang Gao-Smith, Ciro Morgese

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.7field-weighted citation impact, top 16% 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

3 citing papers in PubMed, 9 citations in OpenAlex.

  1. Trial
  2. Review
  3. Review
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

5 authors at 1 institution in 1 country.

Joseph AldermanBirmingham Acute Care Research Centre, University of Birmingham, Birmingham, UK.ORCID 0000-0001-8273-9009
Amit SharmaDepartment of Anaesthesia and Intensive Care Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Jaimin PatelBirmingham Acute Care Research Centre, University of Birmingham, Birmingham, UK.ORCID 0000-0003-4120-3923
Fang Gao-SmithBirmingham Acute Care Research Centre, University of Birmingham, Birmingham, UK.
Ciro MorgeseBirmingham Acute Care Research Centre, University of Birmingham, Birmingham, UK ciro.morgese@nhs.net.ORCID 0000-0002-6140-7627
University Hospitals Birmingham NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo describe current UK clinical practice around the use of intrathecal diamorphine as analgesia for major elective laparoscopic colorectal surgery.

designOnline self-administered survey.

settingAcute public hospitals in the UK (National Health Service - NHS) .

participantsConsultant anaesthetists involved in colorectal surgery lists.

main outcome measuresRate of intrathecal opioids used by anaesthetists for elective laparoscopic colorectal procedures; minimum, most common and maximum doses of intrathecal diamorphine used, timing of administration of intrathecal injection, and relationship between the number of patients anaesthetised for laparoscopic colorectal resections per month by each anaesthetist, and the doses of intrathecal diamorphine they administer.

resultsIn total, 479 responses were received. Of these, 399 (83%) use intrathecal opioid routinely: 351/399 (88%) use diamorphine, 35 (8.8%) use morphine, 8 (2%) use fentanyl, and 7 (1.3%) use other drugs. The median intrathecal diamorphine dose most commonly administered by anaesthetists was 500 µg (IQR 400-750 [(range 200-1500])). The median of the maximum dose administered by anaesthetists was 600 µg (IQR 500-1000 [(range 200-2000])). Greater intrathecal diamorphine dosing was positively associated with higher number of cases per month (rho=0.113, pp=0.033).

conclusionsIntrathecal diamorphine is widely used by UK anaesthetists for patients undergoing major elective laparoscopic colorectal surgery. However, there is little consensus regarding optimal dosing. Therefore, high-quality randomised dose-response trials are needed to investigate the relationship between doses of intrathecal diamorphine and patient outcomes.

Indexed as

AnalgesiaColorectal NeoplasmsColorectal SurgeryAnalgesics, OpioidCross-Sectional StudiesHeroinHumansMorphinePostoperative PainState MedicineUnited KingdomAnalgesics, OpioidHeroinMorphineAdult anaesthesiaColorectal surgeryPain management

Identifiers

PMID35981781
PMCPMC9394208
OpenAlexW4292212798

What OpenQuestion holds

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LicenceCC BY-NC
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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.