Evidence map›Paper›PMID 36740951›Full record

ArticleAsian spine journal2023

A Novel Combined Anesthetic Technique to Improve the Surgical Working Conditions of Lumbar and Thoracolumbar Spine Surgery from a Spine Surgeon's Perspective: A Prospective Randomized Controlled Study.

Meenakshisundaram Subbiah, Kondusamy Manohar Madhuvarshinee, Rabindran John Santha Vinothan, Vijayakumar Poornima, Ragupathy Ramanarayanan, Bose Manikandan, Palaniappan Suresh, Vijay Anto James, Krishnan Yegumuthu

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In one paragraph

Article in Asian spine journal, 2023. 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
1.0field-weighted citation impact, top 27% 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, 3 citations in OpenAlex.

  1. Trial
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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

9 authors at 1 institution in 1 country.

Meenakshisundaram SubbiahDepartment of Orthopaedics & Spine Surgery, Velammal Medical College Hospital and Research Institute, Madurai, India.
Kondusamy Manohar MadhuvarshineeDepartment of Orthopaedics & Spine Surgery, Velammal Medical College Hospital and Research Institute, Madurai, India.
Rabindran John Santha VinothanDepartment of Anaesthesia, Velammal Medical College Hospital and Research Institute, Madurai, India.
Vijayakumar PoornimaDepartment of Anaesthesia, Velammal Medical College Hospital and Research Institute, Madurai, India.
Ragupathy RamanarayananDepartment of Anaesthesia, Velammal Medical College Hospital and Research Institute, Madurai, India.
Bose ManikandanDepartment of Anaesthesia, Velammal Medical College Hospital and Research Institute, Madurai, India.
Palaniappan SureshDepartment of Anaesthesia, Velammal Medical College Hospital and Research Institute, Madurai, India.
Vijay Anto JamesVelammal Medical College Hospital and Research Institute, Madurai, India.
Krishnan YegumuthuDepartment of Pathology, Velammal Medical College Hospital and Research Institute, Madurai, India.
Velammal Medical College Hospital and Research Institute · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designProspective randomized controlled study. PURPOSE: This study aimed to assess the effects of a different combination of anesthetic techniques in lumbar and thoracolumbar spinal surgeries in terms of muscle relaxation and surgical field in addition to hemodynamic parameters. OVERVIEW OF LITERATURE: Adequate relaxation of the erector spinae muscle and good surgical fields are preferred in lumbar spine surgeries. The effects of anesthetic techniques on these parameters have not been evaluated from a surgeon's perspective to date. We propose a novel combined anesthetic technique that improves the working conditions from a surgeon's perspective as we hypothesize that combining general anesthesia (GA) with regional anesthesia (RA) might provide benefits for both techniques.

methodsA prospective randomized study of 76 patients who underwent lumbar and thoracolumbar surgeries was conducted by randomly allocating patients into three anesthetic groups: GA alone, GA with spinal anesthesia (SA), and GA with erector spinae plane block (ESPB) by the allocation concealment method to avoid selection bias. The working conditions were assessed by the same operating surgeon who was blinded by the type of anesthesia to eliminate the assessment bias. Muscle relaxation and surgical field were compared among the three groups along with other hemodynamic parameters to identify any significant differences.

resultsSignificantly better muscle relaxation, surgeon satisfaction, postoperative analgesia, and blood pressure (BP) were observed in the GA+RA when compared to GA alone (p <0.01), whereas no difference was observed between the GA+SA and GA+ESPB groups (p >0.05). Complications were only observed in the GA+SA group (19%).

conclusionsThe study results suggest that the addition of RA to GA may provide better working conditions and surgeon's satisfaction by improving relaxation of the erector spinae in addition to decreasing the BP and postoperative pain in contrast to the use of GA alone. The combined GA and ESPB techniques may be a viable anesthetic alternative to provide better working conditions for surgeons.

Indexed as

Lumbar vertebraeMuscle relaxationNerve blockParaspinal musclesSpine

Identifiers

PMID36740951
PMCPMC10151633
OpenAlexW4319293819

What OpenQuestion holds

Textmetadata
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.