Evidence map›Paper›PMID 41896726›Full record

Trial reportBMC anesthesiology2026

Efficacy of coadministration of calcitonin and hyperbaric bupivacaine in spinal anesthesia for unilateral open inguinal hernia repair in tramadol abuse patients: a randomized controlled trial.

Ibrahim Mamdouh Esmat, Ahmed Kamal Mohamed, Ihab Ahmed Gad, Noha Refaat Mohamed, Sahar Mohamed Talaat, Mohammed Sayed Shorbagy, Tarek Mohamed Ashoor

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04445857 (Efficacy of Coadministration of Calcitonin and Hyperbaric Bupivacaine in Spinal Anesthesia in Lower Abdominal and Limb Surgeries in Tramadol-abuse Patients), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

NCT04445857 phase4completednot on this map

Efficacy of Coadministration of Calcitonin and Hyperbaric Bupivacaine in Spinal Anesthesia in Lower Abdominal and Limb Surgeries in Tramadol-abuse Patients: a Randomized Controlled Trial

TypeinterventionalSponsorAin Shams UniversityRan2020 to 2021Enrolled90ConditionsAnalgesiaArmsCalcitonin presented as Miacalcic® ampoules 100 IU/ml (1ml) intrathecally, Calcitonin presented as Miacalcic® ampoules 100 IU/ml (1ml) intravenously, Normal Saline (NS)
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.

Ibrahim Mamdouh EsmatDepartment of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain-Shams University, Cairo, Egypt. Ibrahim_mamdouh@med.asu.edu.eg.ORCID http://orcid.org/0000-0003-3456-0471
Ahmed Kamal MohamedDepartment of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.ORCID http://orcid.org/0000-0001-6121-8183
Ihab Ahmed GadDepartment of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.ORCID http://orcid.org/0000-0001-9150-5917
Noha Refaat MohamedDepartment of Clinical Pathology, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.ORCID http://orcid.org/0000-0002-8965-243X
Sahar Mohamed TalaatDepartment of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.ORCID http://orcid.org/0000-0001-6624-3345
Mohammed Sayed ShorbagyDepartment of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.ORCID http://orcid.org/0009-0005-0573-469X
Tarek Mohamed AshoorDepartment of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.ORCID http://orcid.org/0000-0003-0289-8101

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTramadol abuse is a socio-economic problem in low resource income communities and was proposed as a cause of failed spinal anesthesia (SA). The research team evaluated coadministration of a single-shot hyperbaric bupivacaine with either intrathecal (IT) or intravenous (IV) calcitonin (CAL) for SA regarding postoperative pain control characteristics and incidence of failed SA in tramadol-abuse patients undergoing unilateral open inguinal hernia repair in a randomized controlled trial.

methodsNinety Egyptian patients were randomized into three equal groups; IT-CAL, IV-CAL and control (C) Groups. All patients received SA, 100 IU calcitonin in IT-CAL Group, 100 IU calcitonin diluted in 10 ml IV normal saline solution (NSS) in IV-CAL Group and NSS in C-Group. The total amount of morphine (rescue analgesic) consumed 24 h following surgery was the primary outcome measure. Secondary outcomes included, incidence of failed SA, time to first request for analgesia, the duration of sensory blockade (duration of analgesia), VAS scores at rest and on movement, CRP level, patient satisfaction with postoperative (PO) pain management and side effects.

resultsOut of 30 randomized patients in each group, failed SA occurred in only one patient in IT-CAL Group while occurred in 8 and 9 patients in IV-CAL and C groups, respectively (P = 0.018). Among the cases with successful SA, the total morphine consumption (19.1 ± 2.9 mg/24h in IT-Cal Group), serum CRP levels and area under the curve of pain scores perceived over 24 h following surgery were significantly lower in IT-Cal Group among the three groups (P < 0.001). Incidence of side effects was comparable between study groups (P > 0.05).

conclusionsOne hundred IU intrathecal calcitonin administration as an adjuvant to hyperbaric bupivacaine was associated with lower total morphine consumption, attenuated stress response and lower incidence of failed spinal anesthesia in tramadol abuse patients undergoing unilateral open inguinal hernia repair when compared with intravenous calcitonin.

trial registrationClinicalTrials.gov Identifier: NCT04445857. IRB: 6379.

Indexed as

Anesthesia, SpinalAnesthetics, LocalBupivacaineHernia, InguinalNarcotic-Related DisordersTramadolAdultAnalgesics, OpioidDouble-Blind MethodFemaleHumansInjections, SpinalMaleMiddle AgedPostoperative PainAnalgesics, OpioidAnesthetics, LocalBupivacaineTramadolCalcitoninC-reactive proteinFailed spinal anesthesiaIntrathecalIntravenousPostoperative painStress responseTramadol abuse

Identifiers

PMID41896726
PMCPMC13045071

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Registered trials

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.