Evidence map›Paper›PMID 39357395›Full record

ArticleJournal of clinical anesthesia2024

National trends in perioperative epidural analgesia use for surgical patients.

Dale N Bongbong, Waseem Abdou, Engy T Said, Rodney A Gabriel

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical anesthesia, 2024. 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
–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

2 citing papers in PubMed.

  1. Article
  2. Review
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

4 authors.

Dale N BongbongSchool of Medicine, University of California, San Diego, La Jolla, CA, USA.
Waseem AbdouSchool of Medicine, University of California, San Diego, La Jolla, CA, USA.
Engy T SaidDivision of Regional Anesthesia, Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA; Division of Perioperative Informatics, Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA; Division of Biomedical Information, Department of Medicine, University of California, San Diego, La Jolla, CA, USA.
Rodney A GabrielDivision of Regional Anesthesia, Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA; Division of Perioperative Informatics, Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA; Division of Biomedical Information, Department of Medicine, University of California, San Diego, La Jolla, CA, USA. Electronic address: ragabriel@health.ucsd.edu.

Funding

San Diego Biomedical Informatics Education & Research (SABER)T15LM011271 · NLM · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SHAMIM NEMATI · 2012 to 2026
$9.7M
NLM NIH HHS T15 LM011271
6 · The paper itself

Abstract

STUDY

objectiveNewer regional anesthesia techniques and minimally invasive surgeries have yielded decreased postoperative pain scores, potentially leading to decreased need for perioperative epidural analgesia. Limited literature is available on trends in usage rates of epidurals. The objective of this study was to identify trends in perioperative epidural analgesia rates among multiple fields of surgery.

methodsAll patients undergoing general, thoracic, urologic, plastic, vascular, orthopedic, or gynecological surgery in 2014-2020 were included from the National Surgical Quality Improvement Program database of over 700 hospitals in the U.S. and 11 different countries. Annual trends in epidural analgesia for all surgeries and each surgical specialty were assessed by mixed effects multivariable logistic regression. The odds ratios (OR) and 99 % confidence intervals (CI) were reported.

resultsThere were 3,111,435 patients from 2014 to 2020 that were included in the final analysis, in which 107,209 (3.4 %) received perioperative epidural analgesia. Among all surgeries combined, epidural use throughout the study period decreased (OR 0.98 per year, 99 % CI 0.97-0.98, P < 0.001). When only analyzing the surgeries with the top 5 most frequent epidural use per specialty, there was no statistically significant trend in epidural utilization (OR 0.99 per year, 99 % CI 0.99-1.00, P = 0.09). However, there was an increasing trend in epidural utilization in general surgery (OR 1.05 per year, 99 % CI 1.03-1.07, P < 0.001) and vascular surgery (OR 1.08 per year, 99 % CI 1.05-1.10, P < 0.001).

conclusionRates of perioperative epidural analgesia use has decreased in recent years overall, however, among surgeries within the general surgery and vascular surgery specialty, utilization has increased for procedures that have the highest rates of usage.

Indexed as

Analgesia, EpiduralPerioperative CarePostoperative PainAdultAgedDatabases, FactualFemaleHumansMaleMiddle AgedSurgical Procedures, OperativeUnited StatesAcute pain serviceEpiduralRegional anesthesia

Identifiers

PMID39357395
PMCPMC11969687

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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.