Evidence map›Paper›PMID 36212234›Full record

ArticleEuropean journal of plastic surgery2023

Transversus abdominus plane blocks do not reduce rates of postoperative prolonged opioid use following abdominally based autologous breast reconstruction: a nationwide longitudinal analysis.

Arhana Chattopadhyay, Jennifer Krupa Shah, Pooja Yesantharao, Vy Thuy Ho, Clifford C Sheckter, Rahim Nazerali

Open access · bronzeAbstract read
In one paragraph

Article in European journal of plastic surgery, 2023. 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
1.2field-weighted citation impact, top 21% 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, 6 citations in OpenAlex.

  1. Review
  2. 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

6 authors at 1 institution in 1 country.

Arhana ChattopadhyayDivision of Plastic and Reconstructive Surgery, Stanford University School of Medicine, 770 Welch Road Suite 400, Palo Alto, 94304 CA USA.
Jennifer Krupa ShahDivision of Plastic and Reconstructive Surgery, Stanford University School of Medicine, 770 Welch Road Suite 400, Palo Alto, 94304 CA USA.
Pooja YesantharaoDivision of Plastic and Reconstructive Surgery, Stanford University School of Medicine, 770 Welch Road Suite 400, Palo Alto, 94304 CA USA.
Vy Thuy HoDivision of Plastic and Reconstructive Surgery, Stanford University School of Medicine, 770 Welch Road Suite 400, Palo Alto, 94304 CA USA.
Clifford C SheckterDivision of Plastic and Reconstructive Surgery, Stanford University School of Medicine, 770 Welch Road Suite 400, Palo Alto, 94304 CA USA.
Rahim NazeraliDivision of Plastic and Reconstructive Surgery, Stanford University School of Medicine, 770 Welch Road Suite 400, Palo Alto, 94304 CA USA.
Stanford University · US

Funding

Stanford Center for Clinical & Translational Education and Research (Spectrum)UL1TR003142 · NCATS · STANFORD UNIVERSITY · PI O'HARA, RUTH M · 2019 to 2023
$45.0M
Spectrum Stanford Center for clinical and Translational Research and EducationUL1TR001085 · NCATS · STANFORD UNIVERSITY · PI CULLEN, MARK RICHARD, GREENBERG, HARRY BERNARD · 2013 to 2017
$37.1M
NCATS NIH HHS UL1 TR001085NCATS NIH HHS UL1 TR003142
6 · The paper itself

Abstract

Background: The transversus abdominus plane (TAP) block reduces postoperative donor site pain in patients undergoing autologous breast reconstruction with an abdominally based flap. This study aimed to determine the effect of TAP blocks on rates of conversion to chronic opioid use. Methods: The Clinformatics Data Mart was queried from 2003 to 2019, extracting adult encounters for abdominally based free and pedicled flaps based on common procedural terminology (CPT) codes. Patients were excluded if they had filled a narcotic prescription 1 year to 30 days prior to surgery. The exposure variable-TAP block-was identified by CPT codes. Outcomes were evaluated using morphine milligram equivalents (MME) from prescriptions filled between 30 days prior to and 30 days after surgery. Chronic opioid use (COU) was defined as receiving 4 unique prescriptions or a 60-day supply between 30 and 180 days after surgery. Results: Of the 4091 patients, (mean age 51.2 ± 9.0 years), 181 (4.4%) had a TAP block placed. Perioperative MMEs/day, postoperative COU, and length of stay did not differ in patients who received a TAP block (p = 0.142; p = 0.271). Significant predictors of risk of conversion to COU included younger age, pedicled abdominal flap, Elixhauser comorbidity index score > 3, filling a psychiatric medication prescription, and filling a benzodiazepine prescription. Conclusions: In patients undergoing autologous breast reconstruction with abdominally based flap reconstruction, TAP blocks do not decrease perioperative MME/day, conversion to chronic opioid use, or length of stay. These data suggest that intraoperative TAP block placement may be a low-yield opioid-reduction strategy.Level of evidence: Level III, risk/prognostic study.

Indexed as

Free flapProlonged opioid use (POU)TAP block

Identifiers

PMID36212234
PMCPMC9530417
OpenAlexW4301398966

What OpenQuestion holds

Textmetadata
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.