Evidence map›Paper›PMID 39780451›Full record

ArticleJournal of surgical oncology2025

Reducing Postoperative Opioid Use: A Comparison of Open Versus Ultrasound-Guided Regional Anesthesia for Patients Undergoing Open Pancreatoduodenectomy.

Parit T Mavani, Caitlin Sok, Pranay S Ajay, Tarrant McPherson, Jeffrey Switchenko, David A Kooby, Mihir M Shah

Abstract readComparative Study
In one paragraph

Article in Journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Parit T MavaniDepartment of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.ORCID http://orcid.org/0000-0003-3968-1205
Caitlin SokDepartment of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Pranay S AjayDepartment of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.ORCID http://orcid.org/0000-0002-9292-8345
Tarrant McPhersonDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health of Emory University, Atlanta, Georgia, USA.
Jeffrey SwitchenkoDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health of Emory University, Atlanta, Georgia, USA.
David A KoobyDepartment of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.ORCID http://orcid.org/0000-0001-8694-0455
Mihir M ShahDepartment of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.ORCID http://orcid.org/0000-0002-4665-5534

Funding

Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE)UL1TR002378 · NCATS · EMORY UNIVERSITY · PI Andres J Garcia, Elizabeth O. Ofili · 2017 to 2026
$92.1M
Winship Cancer Institute Cancer Center Support GrantP30CA138292 · NCI · EMORY UNIVERSITY · PI Ragini Reiney Kudchadkar · 2009 to 2026
$47.5M
Emory Clinical Oncology Career Development Award K12 ProgramK12CA237806 · NCI · EMORY UNIVERSITY · PI DHODAPKAR, KAVITA MADHAV, RAMALINGAM, SURESH S · 2019 to 2023
$2.2M
NCATS NIH HHS UL1 TR002378NCI NIH HHS K12 CA237806NCI NIH HHS P30 CA138292This study was supported by the National Cancer Institute of the National Institute of Health (NIH/NCI) (K12 CA237806 and P30CA138292), Georgia Clinical and Translational Science Alliance (UL1 TR002378) and Contardi Research fellowship.
6 · The paper itself

Abstract

backgroundOpioid crisis is a national issue with significant economic burden and marked increase in opioid-related deaths, particularly following surgical procedures. Reducing opioid requirements while maintaining effective analgesia is critically challenging, perioperatively. Multimodal drug regimens and guided regional anesthesia (RA) have been adopted to address this issue. We aimed to assess postoperative opioid consumption in patients undergoing open pancreatoduodenectomy based on the routes of RA administration: open versus ultra-sound guided.

methodsThis retrospective cohort study was conducted at Emory University Saint Joseph's Hospital, encompassing patients who underwent open pancreatoduodenectomy (PD) from 2020 to 2022 who received ultrasound-guided RA (U-RA) or open RA (O-RA). Patient demographics, surgical details, and postoperative outcomes, including opioid consumption measured in morphine milligram equivalents (MME) at 24, 48, and 72 h, were analyzed. Multivariable linear regression identified predictors of postoperative opioid use.

resultsOf 95 patients, 47 met inclusion criteria: 27 received U-RA and 20 O-RA. Preoperative and intraoperative characteristics were similar between patients receiving O-RA and U-RA. A lower opioid requirement was noted in the O-RA group compared to the U-RA group at all time points. (24 h: 6.5 vs. 18, p = 0.004; 48 h: 18 vs. 37, p = 0.001; 72 h: 30.5 vs. 57, p = 0.002). On multivariable analysis, only route of regional anesthesia was independently associated with reduced opioid use across all time points (24 h: mean difference = -5.75, 95% CI: -11.3, -0.18; 48 h: mean difference = -16.95, 95% CI: -27.5, -6.4; 72 h: mean difference = -20.39, 95% CI: -35.4, -5.3) Patient age, gender, race, obesity, neoadjuvant chemotherapy, small pancreatic duct, and pancreatic fistula were not independently associated with opioid use.

conclusionsO-RA may offer a better approach than U-RA in minimizing opioid consumption after open PD. These findings suggest the incorporation of O-RA for upper abdominal surgeries to decrease the necessity of postoperative opioids.

Indexed as

Analgesics, OpioidAnesthesia, ConductionPancreaticoduodenectomyPostoperative PainUltrasonography, InterventionalAgedFemaleHumansMaleMiddle AgedPancreatic NeoplasmsRetrospective StudiesAnalgesics, Opioidopioidspancreatoduodenectomyregional anesthesiaTAP block

Identifiers

PMID39780451
PMCPMC12187563

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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.