Evidence mapPaperPMID 37542100Full record

Trial reportScientific reports2023

Comparison between multimodal and intraoperative opioid free anesthesia for laparoscopic sleeve gastrectomy: a prospective, randomized study.

Piotr Mieszczański, Grzegorz Górniewski, Paweł Ziemiański, Radosław Cylke, Wojciech Lisik, Janusz Trzebicki

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Scientific reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07073846 (Efficacy of Lidocaine-Dexmedetomidine Combination Therapy in Reducing Post-Operative Pain, Inflammatory Response, and Oxidative Stress in Patients Undergoing Bariatric Surgery), which is not on this map. Cited by 25 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 3 pooled it
12.1field-weighted citation impact, top 1% 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.

NCT07073846 phase4recruitingnot on this mapstarted 2025, after this paper: background citation

Efficacy of Lidocaine-Dexmedetomidine Combination Therapy in Reducing Post-Operative Pain, Inflammatory Response, and Oxidative Stress in Patients Undergoing Bariatric Surgery

TypeinterventionalSponsorInstituto Mexicano del Seguro SocialRan2025 to 2027Enrolled104ConditionsMorbid Obesity Requiring Bariatric Surgery, Postoperative Pain, Postoperative Pain Management, Postoperative AnalgesiaArmsIntravenous Lidocaine infusion + Standard Anesthesia, Intravenous Dexmedetomidine infusion + Standard Anesthesia, Lidocaine + Dexmedetomidine Combination (LIDEX) + Standard Anesthesia, 0.9 % Saline Placebo + Standard Anesthesia
3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 38 citations in OpenAlex.

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  5. Application of oral midazolam for preoperative sedation in pediatric tonsillectomy and adenoidectomy and its effects on emergence delirium.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
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  6. Effect of Dexmedetomidine on the EDDrug design, development and therapy · 2025
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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

6 authors at 2 institutions in 1 country.

Piotr Mieszczański1st Department of Anesthesiology and Intensive Care, Medical University of Warsaw, Warszawa, Poland. piotr.mieszczanski@gmail.com.
Grzegorz Górniewski1st Department of Anesthesiology and Intensive Care, Medical University of Warsaw, Warszawa, Poland.
Paweł ZiemiańskiSzpital Kliniczny Dzieciątka Jezus, ul. Lindleya 4, 02-005, Warszawa, Poland.
Radosław CylkeSzpital Kliniczny Dzieciątka Jezus, ul. Lindleya 4, 02-005, Warszawa, Poland.
Wojciech LisikSzpital Kliniczny Dzieciątka Jezus, ul. Lindleya 4, 02-005, Warszawa, Poland.
Janusz Trzebicki1st Department of Anesthesiology and Intensive Care, Medical University of Warsaw, Warszawa, Poland.
Medical University of Warsaw · PLSzpital Kliniczny Dzieciątka Jezus · PL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Anesthesia for laparoscopic sleeve gastrectomy and perioperative management remains a challenge. Several clinical studies indicate that opioid-free anesthesia (OFA) may be beneficial, but there is no consensus on the most optimal anesthesia technique in clinical practice. The aim of our study was to assess the potential benefits and risks of intraoperative OFA compared to multimodal analgesia (MMA) with remifentanil infusion. In a prospective, randomized study, we analyzed 59 patients' data. Primary outcome measures were oxycodone consumption and reported pain scores (numerical rating scale, NRS) at 1, 6, 12, and 24th hours after surgery. Postoperative sedation on the Ramsay scale, nausea and vomiting on the PONV impact scale, desaturation episodes, pruritus, hemodynamic parameters, and hospital stay duration were also documented and compared. There were no significant differences in NRS scores or total 24-h oxycodone requirements. In the first postoperative hour, OFA group patients needed an average of 4.6 mg of oxycodone while the MMA group 7.72 mg (p = 0.008, p < 0.05 statistically significant). The PONV impact scale was significantly lower in the OFA group only in the first hour after the operation (p = 0.006). Patients in the OFA group required higher doses of ephedrine 23.67 versus 15.69 mg (p = 0.039) and more intravenous fluids 1160 versus 925.86 ml (p = 0.007). The mode of anesthesia did not affect the pain scores or the total dose of oxycodone in the first 24 postoperative hours. Only in the first postoperative hour were an opioid-sparing effect and reduction of PONV incidence seen in the OFA group when compared with remifentanil-based anesthesia. However, patients in the OFA group showed significantly greater hemodynamic lability necessitating higher vasopressor doses and more fluid volume.

Indexed as

AnesthesiaLaparoscopyAnalgesics, OpioidGastrectomyHumansOxycodonePostoperative Nausea and VomitingPostoperative PainProspective StudiesRemifentanilAnalgesics, OpioidOxycodoneRemifentanil

Identifiers

PMID37542100
PMCPMC10403571
OpenAlexW4385577806

What Socratic holds

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LicenceCC BY
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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 Socratic graph.