ArticleFrontiers in medicine2026
Comparative effectiveness of daytime versus nighttime paravertebral block analgesia on intraoperative hemodynamics in older lung cancer patients: a target trial emulation study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Surgery remains the mainstay treatment for older patients with lung cancer, and paravertebral block (PVB) is recommended for perioperative analgesia. With the increasing surgical demand, a growing proportion of elective thoracic procedures in China are scheduled at night. Circadian variation, prolonged fasting, and resource limitations may affect intraoperative hemodynamics. However, the comparative hemodynamic safety of daytime versus nighttime PVB has not been systematically investigated. We emulated a target trial using routinely collected anesthesia and electronic medical records from the Cancer Hospital Chinese Academy of Medical Sciences (Oct-2020 to Jun-2022). Patients aged ≥65 years undergoing lung cancer surgery with PVB were classified into daytime (08:00-16:59) or nighttime (17:00-7:59) groups. Confounding was addressed with stabilized inverse probability of treatment weighting. The primary outcomes were intraoperative hypotension (systolic blood pressure <90 mmHg or diastolic blood pressure <60 mmHg) and bradycardia (heart rate <60 bpm). Secondary outcomes included intravenous fluid volume and vasoactive drug use. Time-to-first and recurrent events were assessed using weighted Cox and Poisson regression. Sensitivity analyses included propensity score matching, restricting to patients with PVB after general anesthesia, and adding surgical type as a covariate. Among 637 patients (479 daytime, 158 nighttime), nighttime PVB was associated with more recurrent hypotension (adjusted-incidence rate ratio [IRR]: 1.04; 95% confidence interval [CI], 1.01-1.09), but no difference in bradycardia (hazard ratio [HR]: 1.11, 95% CI, 0.90-1.36; IRR 1.02, 95%CI 0.98-1.05). Intravenous fluid use was lower at night (mean difference -53.20 mL; 95% CI, -104.36 to -2.04). Findings were robust across sensitivity analyses, with stronger associations in women and patients with hypertension or arrhythmia. We conclude that in older patients undergoing lung cancer surgery, nighttime PVB was linked to a modestly higher burden of hypotension and lower fluid administration compared with daytime PVB. Vigilant monitoring and optimized perioperative management are warranted, and multicenter studies should validate these findings.
Indexed as
Identifiers
What OpenQuestion holds
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.