Evidence map›Paper›PMID 37022606›Full record

ArticleSpine deformity2023

Perioperative multimodal analgesic injection for patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion surgery.

Anthony M Padgett, Seerat Kapoor, Leslie N Rhodes, Katie Keen, Xueyuan Cao, Lindsey L Locke, William C Warner, Jeffrey R Sawyer, Benjamin W Sheffer, David D Spence and 1 more

Abstract read
PubMed Publisher
In one paragraph

Article in Spine deformity, 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
1.9field-weighted citation impact, top 15% 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. Trial
  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

11 authors at 2 institutions in 1 country.

Anthony M PadgettUniversity of Tennessee Health Science Center, College of Medicine, Memphis, TN, USA.ORCID http://orcid.org/0000-0003-1606-0641
Seerat KapoorDepartment of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, Memphis, TN, USA.
Leslie N RhodesLe Bonheur Children's Hospital, Memphis, TN, USA.ORCID http://orcid.org/0000-0002-2441-8554
Katie KeenLe Bonheur Children's Hospital, Memphis, TN, USA.
Xueyuan CaoUniversity of Tennessee Health Science Center, College of Nursing, Memphis, TN, USA.ORCID http://orcid.org/0000-0002-4396-7460
Lindsey L LockeLe Bonheur Children's Hospital, Memphis, TN, USA.ORCID http://orcid.org/0000-0002-6939-6715
William C WarnerDepartment of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, Memphis, TN, USA.ORCID http://orcid.org/0000-0003-1440-0825
Jeffrey R SawyerDepartment of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, Memphis, TN, USA.ORCID https://orcid.org/0000-0001-8461-8614
Benjamin W ShefferDepartment of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, Memphis, TN, USA.
David D SpenceDepartment of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, Memphis, TN, USA.
Derek M KellyDepartment of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, Memphis, TN, USA. dkelly@campbellclinic.com.ORCID http://orcid.org/0000-0002-9113-3858
University of Tennessee Health Science Center · USLe Bonheur Children's Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis retrospective cohort study compared postoperative as-needed (PRN) opioid consumption pre and postimplementation of a perioperative multimodal analgesic injection composed of ropivacaine, epinephrine, ketorolac, and morphine in patients undergoing posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). Secondary outcomes include pain score measurements, time to ambulation, length of stay, blood loss, 90-day complication rate, operating room time, nonopioid medication usage, and total inpatient medication cost before and after the initiation of this practice.

methodsConsecutive patients weighing ≥ 20 kg who underwent PSF for a primary diagnosis of AIS between January 2017 and December 2020 were included. Data from 2018 were excluded to account for standardization of the practice. Patients treated in 2017 only received PCA. Patients treated in 2019 and 2020 only received the injection. Excluded were patients who had any diagnoses other than AIS, allergies to any of the experimental medications, or who were nonambulatory. Data were analyzed utilizing the two-sample t-test or Chi-squared test as appropriate.

resultsResults of this study show that compared with 47 patients treated postoperatively with patient-controlled analgesia (PCA), 55 patients treated with a multimodal perioperative injection have significantly less consumption of PRN morphine equivalents (0.3 mEq/kg vs. 0.5 mEq/kg; p = 0.02). Furthermore, patients treated with a perioperative injection have significantly higher rates of ambulation on postoperative day 1 compared with those treated with PCA (70.9 vs. 40.4%; p = 0.0023).

conclusionAdministration of a perioperative injection is effective and should be considered in the perioperative protocol in patients undergoing PSF for AIS. LEVEL OF EVIDENCE: Therapeutic Level III.

Indexed as

ScoliosisSpinal FusionAdolescentAnalgesicsHumansMorphinePostoperative PainRetrospective StudiesAnalgesicsMorphineMultimodal pain controlPerioperative injectionPosterior spinal fusion

Identifiers

PMID37022606
OpenAlexW4362657749

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.