Evidence map›Paper›PMID 38436828›Full record

ArticleWorld journal of urology2024

Robot-assisted laparoscopic nephrectomy: early outcome measures with the implementation of multimodal analgesia and intrathecal morphine via the acute pain service.

Minhthy N Meineke, Matthew V Losli, Jacklynn F Sztain, Matthew W Swisher, Wendy B Abramson, Erin I Martin, Timothy J Furnish, Amirali Salmasi, Ithaar H Derweesh, Rodney A Gabriel and 1 more

Abstract read
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In one paragraph

Article in World journal of urology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Review
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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

11 authors.

Minhthy N MeinekeDivision of Acute Pain, Department of Anesthesiology, University of California, 9400 Campus Point Dr, San Diego, La Jolla, CA, 92037, USA.
Matthew V LosliDepartment of Anesthesiology, University of California, San Diego, La Jolla, CA, USA.
Jacklynn F SztainDivision of Acute Pain, Department of Anesthesiology, University of California, 9400 Campus Point Dr, San Diego, La Jolla, CA, 92037, USA.
Matthew W SwisherDivision of Acute Pain, Department of Anesthesiology, University of California, 9400 Campus Point Dr, San Diego, La Jolla, CA, 92037, USA.
Wendy B AbramsonDivision of Acute Pain, Department of Anesthesiology, University of California, 9400 Campus Point Dr, San Diego, La Jolla, CA, 92037, USA.
Erin I MartinDivision of Acute Pain, Department of Anesthesiology, University of California, 9400 Campus Point Dr, San Diego, La Jolla, CA, 92037, USA.
Timothy J FurnishDivision of Acute Pain, Department of Anesthesiology, University of California, 9400 Campus Point Dr, San Diego, La Jolla, CA, 92037, USA.
Amirali SalmasiDepartment of Urology, University of California, San Diego, La Jolla, CA, USA.
Ithaar H DerweeshDepartment of Urology, University of California, San Diego, La Jolla, CA, USA.
Rodney A GabrielDivision of Acute Pain, Department of Anesthesiology, University of California, 9400 Campus Point Dr, San Diego, La Jolla, CA, 92037, USA. ragabriel@health.ucsd.edu.ORCID http://orcid.org/0000-0003-4443-0021
Engy T SaidDivision of Acute Pain, Department of Anesthesiology, University of California, 9400 Campus Point Dr, San Diego, La Jolla, CA, 92037, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe objective of this study was to perform a retrospective cohort analysis, in which we measured the association of an acute pain service (APS)-driven multimodal analgesia protocol that included preoperative intrathecal morphine (ITM) compared to historic controls (i.e., surgeon-driven analgesia protocol without ITM) with postoperative opioid use.

methodsThis was a retrospective cohort study in which the primary objective was to determine whether there was a decrease in median 24-h opioid consumption (intravenous morphine equivalents [MEQ]) among robotic nephrectomy patients whose pain was managed by the surgical team prior to the APS, versus pain managed by APS. Secondary outcomes included opioid consumption during the 24-48 h and 48-72 h period and hospital length of stay. To create matched cohorts, we performed 1:1 (APS:non-APS) propensity score matching. Due to the cohorts occurring at the different time periods, we performed a segmented regression analysis of an interrupted time series.

resultsThere were 76 patients in the propensity-matched cohorts, in which 38 (50.0%) were in the APS cohort. The median difference in 24-h opioid consumption in the pre-APS versus APS cohort was 23.0 mg [95% CI 15.0, 31.0] (p < 0.0001), in favor of APS. There were no differences in the secondary outcomes. On segmented regression, there was a statistically significant drop in 24-h opioid consumption in the APS cohort versus pre-APS cohort (p = 0.005).

conclusionsThe implementation of an APS-driven multimodal analgesia protocol with ITM demonstrated a beneficial association with postoperative 24-h opioid consumption following robot-assisted nephrectomy.

Indexed as

AnalgesiaLaparoscopyRoboticsAnalgesics, OpioidHumansMorphineNephrectomyPainPain ClinicsRetrospective StudiesAnalgesics, OpioidMorphineAcute pain serviceIntrathecal morphineMultimodal analgesiaRobotic nephrectomy

Identifiers

PMID38436828
PMCPMC10912429

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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.