Impact of opioid-free anesthesia on complications after deep inferior epigastric perforator flap surgery: A retrospective cohort study

Mulier, Harold; Frene, Bob De; Benmeridja, Lara; Vanhoorebeeck, Florian; Denis, B; Casaer, Bob; Rogge, Fabrice; Leleu, Kris; Mulier, Jan Paul

doi:10.1016/j.bjps.2020.09.004

Cited by 10 publications

(10 citation statements)

References 33 publications

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“…Participants ages ranged from 30 to 75 years, and the BMI in the studies ranged from 23 to 60 kg/m 2 . Four RCTs specifically recruited female patients undergoing breast cancer or gynecologic surgery, [15][16][17][18] and the other 10 studies included surgical procedures for both male and female patients. [19][20][21][22][23][24][25][26][27][28] In the control group, 6 studies used fentanyl alone, and the remaining 8 mostly combinedremifentanil, sufentanil, or morphine.…”

Section: Resultsmentioning

confidence: 99%

Effect of opioid-free anesthesia on the incidence of postoperative nausea and vomiting: A meta-analysis of randomized controlled studies

Zhang,

Ma,

Lang

et al. 2023

Medicine

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Background: Research on opioid-free anesthesia has increased in recent years; however, it has never been determined whether it is more beneficial than opioid anesthesia. This meta-analysis was primarily used to assess the effect of opioid-free anesthesia compared with opioid anesthesia on the incidence of postoperative nausea and vomiting. Methods: We searched the electronic databases of PubMed, the Cochrane Library, Web of Science and Embase from 2014 to 2022 to identify relevant articles and extract relevant data. The incidence of postoperative nausea and vomiting, time to extubation, pain score at 24 hours postoperatively, and time to first postoperative rescue analgesia were compared between patients receiving opioid-free anesthesia and those receiving standard opioid anesthesia. Differences in the incidence of postoperative nausea and vomiting were evaluated using risk ratios (95% confidence interval [CI]). The significance of the differences was assessed using mean differences and 95% CI. The heterogeneity of the subject trials was evaluated using the I 2 test. Statistical analysis was performed using the RevMan 5.4 software. Results: Fourteen randomized controlled trials, including 1354 participants, were evaluated in the meta-analysis. As seen in the forest plot, the OFA group had a lower risk of postoperative nausea and vomiting than the control group (risk ratios = 0.41, 95% CI: 0.33–0.51, P < .00001; n = 1354), and the meta-analysis also found that the OFA group had lower postoperative analgesia scores at 24 hours (P < .000001), but time to extubation (P = .14) and first postoperative resuscitation analgesia time (P < .54) were not significantly different. Conclusions: Opioid-free anesthesia reduces the incidence of postoperative nausea and vomiting while providing adequate analgesia without interfering with postoperative awakening.

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Section: Resultsmentioning

confidence: 99%

Effect of opioid-free anesthesia on the incidence of postoperative nausea and vomiting: A meta-analysis of randomized controlled studies

Zhang,

Ma,

Lang

et al. 2023

Medicine

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“…The market is mainly occupied by foreign products. Therefore, research in related fields in China has a long way to go [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Reconstruction Algorithm-Based Ultrasonic and Spiral CT Images in Evaluating the Effects of Dexmedetomidine Anesthesia for Acute Abdomen

Tian¹,

Zhang

Guo³

2021

Computational and Mathematical Methods in Medicine

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Objective. The study focused on the application value of iteration reconstruction algorithm-based ultrasound and spiral computed tomography (CT) examinations, and the safety of dexmedetomidine anesthesia in acute abdominal surgery. Methods. 80 cases having the acute abdomen surgery were selected as the research subjects. They were divided into group A (40 cases) and group B (40 cases) according to the anesthetic drugs used in the later period. The experimental group was injected with propofol, remifentanil, and atracurium combined with dexmedetomidine; the control group was injected with propofol, remifentanil, and atracurium only. After the operation, the patient was for observed for the pain, agitation, adverse reactions, heart rate (HR), and blood pressure. All patients received ultrasound and spiral CT examinations, and based on the characteristics of the back-projection algorithm, an accelerated algorithm was established and used to process the image, and according to which, the patient’s condition and curative effects were evaluated. Results. After image reconstruction, the ultrasound and spiral CT images were clearer with less noise and more prominent lesions than before reconstruction. Before image reconstruction, the accuracy rates of ultrasound and spiral CT in diagnosing acute abdomen were 92.3% and 91.1%, respectively. After reconstruction, the corresponding numbers were 96.3% and 98.1%, respectively. After reconstruction, the accuracy of the two methods in diagnosing acute abdomen was significantly improved compared with that before reconstruction, and the difference was statistically significant ( P < 0.05 ). The Ramsay score of the experimental group was significantly higher than that of the control group at each time period, P < 0.05 ; the agitation score and visual analogue scale (VAS) score of the experimental group were significantly lower than the control group at each time period after waking up, P < 0.05 . Conclusion. Reconstruction algorithm-based ultrasound and spiral CT images have high application value in the diagnosis of patients with acute abdomen, and dexmedetomidine has good safety in anesthesia surgery.

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“…1). 15–91 A list of all included studies is available in Supplemental Digital Content 3. ( See table, Supplementary Digital Content 3 , which displays characteristics and references of all included studies.…”

Section: Resultsmentioning

confidence: 99%

“Spin” in Observational Studies in Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Systematic Review

Kim

Yuan

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Breast reconstruction after mastectomy in breast cancer patients is known to provide significant improvements in psychological well-being. 1 Among various techniques available, the deep inferior epigastric perforator (DIEP) flap is considered to be the gold standard for autologous breast reconstruction. 2 Despite the clinical importance and high regard of the DIEP flap technique, most research studies in leading plastic surgery journals are nonrandomized and observational in nature. 3 Nonrandomized observational studies on DIEP flap breast reconstruction have shown high risk of bias in their methodology. 2 Nonrandomized observational studies are generally considered to be of lesser quality evidence compared with randomized controlled trials (RCT) and systematic reviews/meta-analyses of RCTs. Nonetheless, observational studies are commonplace in plastic surgery. The prevalence of observational research, in part, is due to being less resource intensive and easier to conduct. 4 Other Breast Original articleBackground: The deep inferior epigastric artery perforator (DIEP) flap is widely used in autologous breast reconstruction. However, the technique relies heavily on nonrandomized observational research, which has been found to have high risk of bias. "Spin" can be used to inappropriately present study findings to exaggerate benefits or minimize harms. The primary objective was to assess the prevalence of spin in nonrandomized observational studies on DIEP reconstruction. The secondary objectives were to determine the prevalence of each spin category and strategy. Methods: MEDLINE and Embase databases were searched from January 1, 2015, to November 15, 2022. Spin was assessed in abstracts and full-texts of included studies according to criteria proposed by Lazarus et al. Results: There were 77 studies included for review. The overall prevalence of spin was 87.0%. Studies used a median of two spin strategies (interquartile range: 1-3). The most common strategies identified were causal language or claims (n = 41/77, 53.2%), inadequate extrapolation to larger population, intervention, or outcome (n = 27/77, 35.1%), inadequate implication for clinical practice (n = 25/77, 32.5%), use of linguistic spin (n = 22/77, 28.6%), and no consideration of the limitations (n = 21/77, 27.3%). There were no significant associations between selected study characteristics and the presence of spin. Conclusions:The prevalence of spin is high in nonrandomized observational studies on DIEP reconstruction. Causal language or claims are the most common strategy. Investigators, reviewers, and readers should familiarize themselves with spin strategies to avoid misinterpretation of research in DIEP reconstruction.

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Impact of opioid-free anesthesia on complications after deep inferior epigastric perforator flap surgery: A retrospective cohort study

Cited by 10 publications

References 33 publications

Effect of opioid-free anesthesia on the incidence of postoperative nausea and vomiting: A meta-analysis of randomized controlled studies

Effect of opioid-free anesthesia on the incidence of postoperative nausea and vomiting: A meta-analysis of randomized controlled studies

Reconstruction Algorithm-Based Ultrasonic and Spiral CT Images in Evaluating the Effects of Dexmedetomidine Anesthesia for Acute Abdomen

“Spin” in Observational Studies in Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Systematic Review

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