Evidence map›Paper›PMID 36611262›Full record

SynthesisBJS open2023

Impact of perioperative α1-antagonists on postoperative urinary retention in orthopaedic surgery: meta-analysis.

Yun-Ting Huang, Yu Chang, Yi-No Kang, Chin-Hsuan Huang, Yu-Shiuan Lin, Jeffrey Wu, Kuan-Yu Chi, Wei-Cheng Chen

Open access · goldAbstract readMeta-Analysis
In one paragraph

Synthesis in BJS open, 2023. 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
–field-weighted citation impact, top 100% 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, 0 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

8 authors at 4 institutions in 1 country.

Yun-Ting HuangDepartment of Anesthesiology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Yu ChangDepartment of Surgery, Section of Neurosurgery Department, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
Yi-No KangDepartment of Education, Center for Evidence-Based Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
Chin-Hsuan HuangDepartment of Education, Center for Evidence-Based Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
Yu-Shiuan LinDepartment of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
Jeffrey WuDepartment of Orthopaedics, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
Kuan-Yu ChiDepartment of Education, Center for Evidence-Based Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
Wei-Cheng ChenDepartment of Orthopaedics, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
Taipei Medical University Hospital · TWNational Cheng Kung University Hospital · TWTaipei Medical University-Shuang Ho Hospital · TWTaipei Tzu Chi Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostoperative urinary retention (POUR) is a common complication following orthopaedic surgery. Previous studies attempted to establish the preventative role of α1-antagonist in POUR in the general surgical population; however, there is still no consensus regarding its use in orthopaedic surgery due to limited evidence.

methodsElectronic databases of Cochrane Library, Embase, MEDLINE, and ClinicalTrials.gov were searched by two independent investigators from inception to 1 March 2022 to identify relevant randomized clinical trials. Two reviewers independently completed a critical appraisal of included trials by using the Cochrane Risk of Bias tool version 2.0 and extracted data from included articles. Risk of POUR was summarized as risk ratio (RR) with 95 per cent confidence intervals (c.i.). Mean difference (MD) was used for meta-analysis of continuous outcomes.

resultsFive randomized clinical trials involving 878 patients (α1-antagonist, 434; placebo, 444) undergoing hip/knee arthroplasty and spine surgeries were included. One study was assessed as high risk of bias from the randomization process and was excluded from the final meta-analysis. There was no difference in the risk of POUR between patients taking α1-antagonist and the placebo in arthroplasty (RR, 0.64; 95 per cent c.i., 0.36 to 1.14) and in spine surgeries (RR, 1.03; 95 per cent c.i., 0.69 to 1.55). There was no difference in length of stay (MD, -0.14 days; 95 per cent c.i., -0.33 to 0.05). Use of α1-antagonist was associated with a higher risk of adverse events (RR, 1.97; 95 per cent c.i., 1.27 to 3.06), with a composite of dizziness, light-headedness, fatigue, altered mental status, and syncope being the most commonly reported symptoms.

conclusionIn patients undergoing spinal surgery and joint arthroplasty, routine administration of perioperative α1-antagonist does not decrease risk of POUR but does increase perioperative dizziness, light-headedness, and syncope.

Indexed as

Orthopedic ProceduresUrinary RetentionDizzinessHumansMinor Histocompatibility AntigensPostoperative ComplicationsProto-Oncogene Proteins c-bcl-2SyncopeBCL2-related protein A1Minor Histocompatibility AntigensProto-Oncogene Proteins c-bcl-2

Identifiers

PMID36611262
PMCPMC9825733
OpenAlexW4313706664

What OpenQuestion holds

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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.