Evidence map›Paper›PMID 38331658›Full record

ArticleBritish journal of anaesthesia2024

Intraoperative pharmacologic opioid minimisation strategies and patient-centred outcomes after surgery: a scoping review.

Michael Verret, Nhat H Lam, Manoj Lalu, Stuart G Nicholls, Alexis F Turgeon, Daniel I McIsaac, Myriam Hamtiaux, John Bao Phuc Le, Ian Gilron, Lucy Yang and 23 more

Abstract readScoping Review
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of anaesthesia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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

7 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Review
  6. Article
  7. 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

33 authors.

Michael VerretClinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada; Department of Anesthesiology and Pain Medicine, University of Ottawa, Civic Campus, The Ottawa Hospital, Ottawa, ON, Canada; Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec City, QC, Canada. Electronic address: mverr051@uottawa.ca.
Nhat H LamClinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Manoj LaluClinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada; Department of Anesthesiology and Pain Medicine, University of Ottawa, Civic Campus, The Ottawa Hospital, Ottawa, ON, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Stuart G NichollsClinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada; Ottawa Methods Centre, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Alexis F TurgeonDepartment of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec City, QC, Canada; Population Health and Optimal Health Practices Research Unit (Trauma - Emergency - Critical Care Medicine), Centre de Recherche du CHU de Québec-Université Laval, Université Laval, Québec City, QC, Canada.
Daniel I McIsaacClinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada; Department of Anesthesiology and Pain Medicine, University of Ottawa, Civic Campus, The Ottawa Hospital, Ottawa, ON, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Myriam HamtiauxClinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
John Bao Phuc LeClinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Ian GilronDepartment of Anesthesiology & Perioperative Medicine, Biomedical & Molecular Sciences, Centre for Neuroscience Studies and School of Policy Studies, Queen's University, Kingston, ON, Canada.
Lucy YangFaculty of Medicine, University of Calgary, Calgary, AB, Canada.
Mahrukh KaimkhaniFaculty of Medicine, University of Calgary, Calgary, AB, Canada.
Alexandre AssiSchool of Medicine, Trinity College Dublin, Dublin, Ireland.
David El-AdemFaculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
Makenna TimmFaculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Peter TaiFaculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
Joelle AmirFaculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
Sriyathavan SrichandramohanClinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Abdulaziz Al-MazidiClinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Nicholas A FergussonDepartment of Anesthesiology, Perioperative & Pain Medicine, University of Calgary, Calgary, AB, Canada.
Brian HuttonClinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada.
Fiona ZivkovicPatient partner, The Ottawa Hospital, Ottawa, ON, Canada.
Megan GrahamPatient partner, The Ottawa Hospital, Ottawa, ON, Canada.
Maxime LêPatient partner, The Ottawa Hospital, Ottawa, ON, Canada.
Allison GeistPatient partner, The Ottawa Hospital, Ottawa, ON, Canada.
Mélanie BérubéPopulation Health and Optimal Health Practices Research Unit (Trauma - Emergency - Critical Care Medicine), Centre de Recherche du CHU de Québec-Université Laval, Université Laval, Québec City, QC, Canada; Faculty of Nursing, Université Laval, Québec City, QC, Canada; Quebec Pain Research Network, Sherbrooke, QC, Canada.
Patricia PoulinClinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada.
Risa ShorrLibrary Services, The Ottawa Hospital, Ottawa, ON, Canada.
Helena DaudtPain Canada, Pain BC, Vancouver, BC, Canada.
Guillaume MartelClinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada.
Jason McVicarClinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada; Department of Anesthesiology and Pain Medicine, University of Ottawa, Civic Campus, The Ottawa Hospital, Ottawa, ON, Canada.
Husein MolooClinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada.
Dean A FergussonClinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Perioperative Anesthesia Clinical Trials (PACT) group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostoperative patient-centred outcome measures are essential to capture the patient's experience after surgery. Although a large number of pharmacologic opioid minimisation strategies (i.e. opioid alternatives) are used for patients undergoing surgery, it remains unclear which strategies are most promising in terms of patient-centred outcome improvements. This scoping review had two main objectives: (1) to map and describe evidence from clinical trials assessing the patient-centred effectiveness of pharmacologic intraoperative opioid minimisation strategies in adult surgical patients, and (2) to identify promising pharmacologic opioid minimisation strategies.

methodsWe searched MEDLINE, Embase, CENTRAL, Web of Science, and CINAHL databases from inception to February 2023. We included trials investigating the use of opioid minimisation strategies in adult surgical patients and reporting at least one patient-centred outcome. Study screening and data extraction were conducted independently by at least two reviewers.

resultsOf 24,842 citations screened for eligibility, 2803 trials assessed the effectiveness of intraoperative opioid minimisation strategies. Of these, 457 trials (67,060 participants) met eligibility criteria, reporting at least one patient-centred outcome. In the 107 trials that included a patient-centred primary outcome, patient wellbeing was the most frequently used domain (55 trials). Based on aggregate findings, dexmedetomidine, systemic lidocaine, and COX-2 inhibitors were promising strategies, while paracetamol, ketamine, and gabapentinoids were less promising. Almost half of the trials (253 trials) did not report a protocol or registration number.

conclusionsResearchers should prioritise and include patient-centred outcomes in the assessment of opioid minimisation strategy effectiveness. We identified three potentially promising pharmacologic intraoperative opioid minimisation strategies that should be further assessed through systematic reviews and multicentre trials. Findings from our scoping review may be influenced by selective outcome reporting bias. STUDY REGISTRATION: OSF - https://osf.io/7kea3.

Indexed as

Analgesics, OpioidLidocaineAdultHumansOutcome Assessment, Health CareAnalgesics, OpioidLidocaineadult anaesthesiaclinical pharmacologyopioid minimisation strategiespain managementpatient-centred outcomes

Identifiers

PMID38331658
PMCPMC10925893

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.