{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T15:50:38Z","timestamp":1779205838403,"version":"3.51.4"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T00:00:00Z","timestamp":1662076800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T00:00:00Z","timestamp":1662076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["OBES SURG"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract\n<\/jats:title><jats:sec>\n                <jats:title>Background\n<\/jats:title>\n                <jats:p>Visceral pain (VP) following laparoscopic sleeve gastrectomy remains a substantial problem. VP is associated with autonomic symptoms, especially nausea and vomiting, and is unresponsive to traditional pain management algorithms aimed at alleviating somatic (incisional) pain. The present study was performed to evaluate the safety and effectiveness of laparoscopic paragastric autonomic neural blockade (PG-ANB) in managing the symptoms associated with VP following sleeve gastrectomy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Study Design<\/jats:title>\n                <jats:p>This prospective, double-blinded, randomized clinical trial involved patients undergoing laparoscopic sleeve gastrectomy at two high-volume institutions. The patients were randomized to laparoscopic transversus abdominis plane block with or without PG-ANB. The primary outcome was patient-reported pain scores assessed at 1, 8, and 24\u00a0h postoperatively. The secondary outcome measures were analgesic requirements, nausea, vomiting, hiccups, and hemodynamic changes immediately after PG-ANB and postoperatively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In total, 145 patients (block group, <jats:italic>n<\/jats:italic>\u2009=\u200972; control group, <jats:italic>n<\/jats:italic>\u2009=\u200973) were included in the study. The heart rate and mean arterial pressure significantly decreased 10\u00a0min after PG-ANB. The visual analog scale score for pain was significantly lower in the PG-ANB than in the control group at 1\u00a0h postoperatively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and 8\u00a0h postoperatively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Vomiting, nausea, sialorrhea, and hiccups were significantly less prevalent in the PG-ANB group. Patients in the PG-ANB group received fewer cumulative doses of analgesics at 1\u00a0h postoperatively (<jats:italic>p<\/jats:italic>\u2009=\u20090.003) and 8\u00a0h postoperatively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). No differences between the groups were detected at 24\u00a0h (<jats:italic>p<\/jats:italic>\u2009=\u20090.298). No complications related to PG-ANB occurred.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>PG-ANB safely and effectively reduces early VP, associated autonomic symptoms, and analgesic requirements after laparoscopic sleeve gastrectomy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s11695-022-06257-9","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T23:02:51Z","timestamp":1662073371000},"page":"3551-3560","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Paragastric Autonomic Neural Blockade to Prevent Early Visceral Pain and Associated Symptoms After Laparoscopic Sleeve Gastrectomy: a Randomized Clinical Trial"],"prefix":"10.1007","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3125-6602","authenticated-orcid":false,"given":"Jorge","family":"Daes","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Morrell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9s","family":"Hanssen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Caballero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elika","family":"Luque","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Pantoja","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Luquetta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric M.","family":"Pauli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,9,2]]},"reference":[{"key":"6257_CR1","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1097\/00000539-199508000-00029","volume":"81","author":"J Joris","year":"1995","unstructured":"Joris J, Thiry E, Paris P, et al. 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Andres Hanssen has received honoraria from Medtronic and Johnson & Johnson concerning hernia surgery. David J Morrell, Melissa Caballero, Elika Luque, Rafael Pantoja, Jorge Luquetta, and Eric Pauli declare that they do not have a conflict of interest concerning the publication of this manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}}]}}