Evidence map›Paper›PMID 30719556›Full record

SynthesisWorld journal of surgery2019

Evidence-Based Management of Postoperative Pain in Adults Undergoing Laparoscopic Sleeve Gastrectomy.

Hoani Macfater, Weisi Xia, Sanket Srinivasa, Andrew Graham Hill, Marc Van De Velde, Girsh P Joshi, PROSPECT collaborators

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in World journal of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 4 pooled it
3.1field-weighted citation impact, top 9% of its field
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

20 citing papers in PubMed, 4 syntheses or guidelines pooled it, 50 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 3 countries.

Hoani MacfaterDepartment of Surgery, South Auckland Clinical Campus, Middlemore Hospital, The University of Auckland, Auckland, New Zealand.
Weisi XiaDepartment of Surgery, South Auckland Clinical Campus, Middlemore Hospital, The University of Auckland, Auckland, New Zealand.
Sanket SrinivasaDepartment of Surgery, South Auckland Clinical Campus, Middlemore Hospital, The University of Auckland, Auckland, New Zealand.
Andrew Graham HillDepartment of Surgery, South Auckland Clinical Campus, Middlemore Hospital, The University of Auckland, Auckland, New Zealand.
Marc Van De VeldeDepartment of University Hospital Leuven, Louvain, Belgium.
Girsh P JoshiDepartment of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9068, USA. girish.joshi@utsouthwestern.edu.
PROSPECT collaborators
The University of Texas Southwestern Medical Center · USUniversity of Auckland · NZKU Leuven · BEUCLouvain · BEMiddlemore Hospital · NZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLaparoscopic sleeve gastrectomy (LSG) is a common weight loss operation that is increasingly being managed on an outpatient or overnight stay basis. The aim of this systematic review was to evaluate the available literature and develop recommendations for optimal pain management after LSG.

methodsA systematic review utilizing preferred reporting items for systematic reviews and meta-analysis with PROcedure SPECific Postoperative Pain ManagemenT methodology was undertaken. Randomized controlled trials (RCTs) published in the English language from inception to September 2018 assessing postoperative pain using analgesic, anesthetic, and surgical interventions were identified from MEDLINE, EMBASE and Cochrane Databases.

resultsSignificant heterogeneity was identified in the 18 RCTs included in this systematic review. Gabapentinoids and transversus abdominis plane blocks reduced LSG postoperative pain. There was limited procedure-specific evidence of analgesic effects for acetaminophen, non-steroidal anti-inflammatory drugs, dexamethasone, magnesium, and tramadol in this setting. Inconsistent evidence was found in the studies investigating alpha-2-agonists. No evidence was found for intraperitoneal local anesthetic administration or single-port laparoscopy.

conclusionsThe literature to recommend an optimal analgesic regimen for LSG is limited. The pragmatic view supports acetaminophen and a non-steroidal anti-inflammatory drug, with opioids as rescue analgesics. Gabapentinoids should be used with caution, as they may amplify opioid-induced respiratory depression. Although transversus abdominis plane blocks reduced pain, port-site infiltration may be considered instead, as it is a simple and inexpensive approach that provides adequate somatic blockade. Further RCTs are required to confirm the influence of the recommended analgesic regimen on postoperative pain relief.

Indexed as

LaparoscopyAdrenergic alpha-2 Receptor AgonistsAnalgesia, EpiduralAnalgesics, Non-NarcoticAnesthetics, LocalAnti-Inflammatory AgentsGastrectomyHumansNerve BlockPostoperative PainRandomized Controlled Trials as TopicAdrenergic alpha-2 Receptor AgonistsAnalgesics, Non-NarcoticAnesthetics, LocalAnti-Inflammatory Agents

Identifiers

PMID30719556
OpenAlexW2912885791

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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 Socratic graph.