Evidence map›Paper›PMID 38829406›Full record

Trial reportJournal of anesthesia2024

Ultrasound-guided erector spinae plane block versus thoracic epidural block for postoperative analgesia in pediatric Nuss surgery: a randomized noninferiority trial.

Yi Ren, Xiaolu Nie, Fuzhou Zhang, Yangwei Ma, Lei Hua, Tiehua Zheng, Zenghua Xu, Jia Gao, Jianmin Zhang

Abstract readRandomized Controlled TrialComparative StudyEquivalence Trial
PubMed Publisher
In one paragraph

Trial report in Journal of anesthesia, 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. Article
  2. Article
  3. Review
  4. 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

9 authors.

Yi Ren *Department of Anesthesiology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, No. 56, South Lishi Road, Beijing, 100045, China.
Xiaolu Nie *Center for Clinical Epidemiology and Evidence-Based Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, 100045, China.
Fuzhou ZhangDepartment of Anesthesiology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, No. 56, South Lishi Road, Beijing, 100045, China.
Yangwei MaDepartment of Anesthesiology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, No. 56, South Lishi Road, Beijing, 100045, China.
Lei HuaDepartment of Anesthesiology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, No. 56, South Lishi Road, Beijing, 100045, China.
Tiehua ZhengDepartment of Anesthesiology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, No. 56, South Lishi Road, Beijing, 100045, China.
Zenghua XuDepartment of Anesthesiology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, No. 56, South Lishi Road, Beijing, 100045, China.
Jia GaoDepartment of Anesthesiology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, No. 56, South Lishi Road, Beijing, 100045, China.
Jianmin ZhangDepartment of Anesthesiology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, No. 56, South Lishi Road, Beijing, 100045, China. zhangjianmin@bch.com.cn.

Funding

Wu Jieping Medical Foundation 320.6750.19089-102
6 · The paper itself

Abstract

purposeThoracic epidural anesthesia (TEA) is often used for analgesia after thoracic surgery. Erector spinae plane block (ESPB) has been proposed to provide adequate analgesia. We hypothesized that ESPB would be noninferior to TEA as a part of multimodal analgesia in pediatric patients undergoing the Nuss procedure.

methodsPatients aged 7-18 years and scheduled for the Nuss procedure were randomly allocated to receive bilateral single-shot ESPB or TEA and a multimodal analgesic regimen including parent-controlled intravenous analgesia (PCIA). At 6 h, 12 h, 18 h, and 24 h postoperatively, pain was evaluated using the numeric rating scale (NRS) and opioid consumption was assessed by counting the number of PCIA boluses. The joint primary outcomes were the average pain score and opioid consumption at 24 h after surgery. The secondary outcomes were the NRS scores and the number of opioid boluses administered at different postoperative time points, adverse events, and recovery quality.

resultsThree hundred patients underwent randomization, and 286 received ESPB (147 patients) or TEA (139 patients). At 24 h postoperatively, ESPB was noninferior to TEA in terms of the average NRS score (mean difference, - 0.1, 95% confidence interval [CI], - 0.3-0.1, margin = 1, P for noninferiority < 0.001) and the number of opioid boluses administered (mean difference, - 1.1, 95% CI, - 2.8-0.6, margin = 7, P for noninferiority < 0.001). Adverse events and patient recovery were comparable between groups.

conclusionsThe results demonstrate that combined with a multimodal analgesia, ESPB provides noninferior analgesia compared to TEA with respect to pain score and opioid consumption among pediatric patients undergoing the Nuss procedure.

Indexed as

Nerve BlockPostoperative PainUltrasonography, InterventionalAdolescentAnalgesia, EpiduralAnalgesics, OpioidChildFemaleFunnel ChestHumansMalePain MeasurementParaspinal MusclesThoracic VertebraeTreatment OutcomeAnalgesics, OpioidErector spinae plane blockNoninferior testPediatricsPostoperative analgesiaThe Nuss procedure

Identifiers

PMID38829406

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Registered trials

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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.