{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T02:58:15Z","timestamp":1784257095242,"version":"3.55.0"},"reference-count":48,"publisher":"Elsevier BV","issue":"7","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jcardioanesthesia.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Cardiothoracic and Vascular Anesthesia"],"published-print":{"date-parts":[[2023,7]]},"DOI":"10.1053\/j.jvca.2023.03.018","type":"journal-article","created":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T21:53:51Z","timestamp":1679090031000},"page":"1169-1178","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":11,"title":["Comparative Efficacy of Adjuvant Nonopioid Analgesia in Adult Cardiac Surgical Patients: A Network Meta-Analysis"],"prefix":"10.1053","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4465-2249","authenticated-orcid":false,"given":"Kiyan","family":"Heybati","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6236-764X","authenticated-orcid":false,"given":"Fangwen","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew Joseph","family":"Lynn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8274-6468","authenticated-orcid":false,"given":"Jiawen","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saif","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenteng","family":"Hou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8284-4327","authenticated-orcid":false,"given":"Shayan","family":"Heybati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosta","family":"Tzanis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Krever","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafay","family":"Mughal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8785-5092","authenticated-orcid":false,"given":"Harish","family":"Ramakrishna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1053\/j.jvca.2023.03.018_bib0001","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1213\/01.ane.0000263034.96885.e1","article-title":"The role of the anesthesiologist in fast-track surgery: From multimodal analgesia to perioperative medical care","volume":"104","author":"White","year":"2007","journal-title":"Anesth Analg"},{"key":"10.1053\/j.jvca.2023.03.018_bib0002","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/j.athoracsur.2019.06.019","article-title":"Impact of prescribing on new persistent opioid use after cardiothoracic surgery","volume":"108","author":"Brescia","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"10.1053\/j.jvca.2023.03.018_bib0003","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/j.athoracsur.2019.12.031","article-title":"New persistent opioid use after aortic and mitral valve surgery in commercially insured patients","volume":"110","author":"Clement","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"10.1053\/j.jvca.2023.03.018_bib0004","doi-asserted-by":"crossref","DOI":"10.1016\/j.jtcvs.2019.09.137","article-title":"Predictors of new persistent opioid use after coronary artery bypass grafting","volume":"160","author":"Clement","year":"2020","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1053\/j.jvca.2023.03.018_bib0005","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1001\/jamacardio.2020.1445","article-title":"Development of persistent opioid use after cardiac surgery","volume":"5","author":"Brown","year":"2020","journal-title":"JAMA Cardiol"},{"key":"10.1053\/j.jvca.2023.03.018_bib0006","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/j.pain.2012.12.025","article-title":"Intravenous acetaminophen reduces postoperative nausea and vomiting: A systematic review and meta-analysis","volume":"154","author":"Apfel","year":"2013","journal-title":"Pain"},{"key":"10.1053\/j.jvca.2023.03.018_bib0007","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1053\/j.jvca.2013.06.022","article-title":"Perioperative dexmedetomidine improves mortality in patients undergoing coronary artery bypass surgery","volume":"28","author":"Ji","year":"2014","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"10.1053\/j.jvca.2023.03.018_bib0008","doi-asserted-by":"crossref","first-page":"180","DOI":"10.4103\/0971-9784.114239","article-title":"Efficacy of perioperative pregabalin in acute and chronic post-operative pain after off-pump coronary artery bypass surgery: A randomized, double-blind placebo controlled trial","volume":"16","author":"Joshi","year":"2013","journal-title":"Ann Card Anaesth"},{"key":"10.1053\/j.jvca.2023.03.018_bib0009","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1053\/j.jvca.2009.10.023","article-title":"Effects of single-dose gabapentin on postoperative pain and morphine consumption after cardiac surgery","volume":"24","author":"Menda","year":"2010","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"10.1053\/j.jvca.2023.03.018_bib0010","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1001\/jamasurg.2019.1153","article-title":"Guidelines for perioperative care in cardiac surgery: Enhanced recovery after surgery society recommendations","volume":"154","author":"Engelman","year":"2019","journal-title":"JAMA Surg"},{"key":"10.1053\/j.jvca.2023.03.018_bib0011","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1097\/DCR.0000000000001281","article-title":"Systematic review and meta-analysis of nonsteroidal anti-inflammatory drugs to Improve GI recovery after colorectal surgery","volume":"62","author":"Chapman","year":"2019","journal-title":"Dis Colon Rectum"},{"key":"10.1053\/j.jvca.2023.03.018_bib0012","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1093\/bja\/aeq406","article-title":"Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs for the reduction in morphine-related side-effects after major surgery: A systematic review","volume":"106","author":"Maund","year":"2011","journal-title":"Br J Anaesth"},{"key":"10.1053\/j.jvca.2023.03.018_bib0013","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.jclinane.2017.08.030","article-title":"Nonsteroidal anti-inflammatory drugs for postoperative pain control after lumbar spine surgery: A meta-analysis of randomized controlled trials","volume":"43","author":"Zhang","year":"2017","journal-title":"J Clin Anesth"},{"key":"10.1053\/j.jvca.2023.03.018_bib0014","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1001\/jama.2018.22039","article-title":"Effect of combination of paracetamol (acetaminophen) and ibuprofen vs either alone on patient-controlled morphine consumption in the first 24 hours after total hip arthroplasty: The PANSAID randomized clinical trial","volume":"321","author":"Thybo","year":"2019","journal-title":"JAMA"},{"key":"10.1053\/j.jvca.2023.03.018_bib0015","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1111\/j.1365-2044.2008.05674.x","article-title":"Peri-operative use of paracetamol","volume":"64","author":"Oscier","year":"2009","journal-title":"Anaesthesia"},{"key":"10.1053\/j.jvca.2023.03.018_bib0016","article-title":"Intravenous paracetamol reduces postoperative opioid consumption after orthopedic surgery: A systematic review of clinical trials","volume":"2013","author":"Jebaraj","year":"2013","journal-title":"Pain Res Treat"},{"key":"10.1053\/j.jvca.2023.03.018_bib0017","doi-asserted-by":"crossref","first-page":"400","DOI":"10.4184\/asj.2014.8.4.400","article-title":"The effect of intravenous paracetamol on postoperative pain after lumbar discectomy","volume":"8","author":"Shimia","year":"2014","journal-title":"Asian Spine J"},{"key":"10.1053\/j.jvca.2023.03.018_bib0018","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1053\/j.jvca.2016.03.127","article-title":"Effect of oxycodone combined with dexmedetomidine for intravenous patient-controlled analgesia after video-assisted thoracoscopic lobectomy","volume":"30","author":"Wang","year":"2016","journal-title":"j Cardiothorac Vasc Anesth"},{"key":"10.1053\/j.jvca.2023.03.018_bib0019","doi-asserted-by":"crossref","first-page":"e3814","DOI":"10.1097\/MD.0000000000003814","article-title":"Effects of intraoperative dexmedetomidine on postoperative pain in Highly nicotine-dependent patients after thoracic surgery: A prospective, randomized, controlled trial","volume":"95","author":"Cai","year":"2016","journal-title":"Medicine"},{"key":"10.1053\/j.jvca.2023.03.018_bib0020","doi-asserted-by":"crossref","first-page":"301","DOI":"10.4097\/kjae.2013.64.4.301","article-title":"Antihyperalgesic effects of dexmedetomidine on high-dose remifentanil-induced hyperalgesia","volume":"64","author":"Lee","year":"2013","journal-title":"Korean J Anesthesiol"},{"key":"10.1053\/j.jvca.2023.03.018_bib0021","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1053\/j.jvca.2006.11.013","article-title":"Role of magnesium sulfate in postoperative pain management for patients undergoing thoracotomy","volume":"21","author":"Ozcan","year":"2007","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"10.1053\/j.jvca.2023.03.018_bib0022","doi-asserted-by":"crossref","first-page":"e13583","DOI":"10.1097\/MD.0000000000013583","article-title":"The use of intravenous magnesium sulfate on postoperative analgesia in orthopedic surgery: A systematic review of randomized controlled trials","volume":"97","author":"Peng","year":"2018","journal-title":"Medicine"},{"key":"10.1053\/j.jvca.2023.03.018_bib0023","doi-asserted-by":"crossref","first-page":"777","DOI":"10.7326\/M14-2385","article-title":"The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: Checklist and explanations","volume":"162","author":"Hutton","year":"2015","journal-title":"Ann Intern Med"},{"key":"10.1053\/j.jvca.2023.03.018_bib0024","unstructured":"Higgins J, Thomas J, eds. Cochrane handbook for systematic reviews of interventions. Second ed. Available at: https:\/\/onlinelibrary.wiley.com\/doi\/book\/10.1002\/9781119536604. Accessed April 12, 2022."},{"key":"10.1053\/j.jvca.2023.03.018_bib0025","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"10.1053\/j.jvca.2023.03.018_bib0026","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003082","article-title":"CINeMA: An approach for assessing confidence in the results of a network meta-analysis","volume":"17","author":"Nikolakopoulou","year":"2020","journal-title":"PLoS Med"},{"key":"10.1053\/j.jvca.2023.03.018_bib0027","doi-asserted-by":"crossref","first-page":"157","DOI":"10.12688\/wellcomeopenres.14738.1","article-title":"The development and evaluation of an online application to assist in the extraction of data from graphs for use in systematic reviews","volume":"3","author":"Cramond","year":"2018","journal-title":"Wellcome Open Res"},{"key":"10.1053\/j.jvca.2023.03.018_bib0028","unstructured":"MDCalc. Morphine milligram equivalents (MME) calculator. Available at: https:\/\/www.mdcalc.com\/morphine-milligram-equivalents-mme-calculator. Accessed June 16, 2022."},{"key":"10.1053\/j.jvca.2023.03.018_bib0029","unstructured":"Centers for Disease Control and Prevention. Clinical tools for primary care providers. Available at: https:\/\/www.cdc.gov\/opioids\/providers\/prescribing\/clinical-tools.html. Accessed June 16, 2022."},{"key":"10.1053\/j.jvca.2023.03.018_bib0030","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1177\/0962280216669183","article-title":"Optimally estimating the sample mean from the sample size, median, mid-range, and\/or mid-quartile range","volume":"27","author":"Luo","year":"2018","journal-title":"Stat Methods Med Res"},{"key":"10.1053\/j.jvca.2023.03.018_bib0031","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1002\/jrsm.1429","article-title":"Optimally estimating the sample standard deviation from the five-number summary","volume":"11","author":"Shi","year":"2020","journal-title":"Res Synth Methods"},{"key":"10.1053\/j.jvca.2023.03.018_bib0032","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1186\/1471-2288-14-135","article-title":"Estimating the sample mean and standard deviation from the sample size, median, range and\/or interquartile range","volume":"14","author":"Wan","year":"2014","journal-title":"BMC Med Res Methodol"},{"key":"10.1053\/j.jvca.2023.03.018_bib0033","unstructured":"Shi J, Luo D, Wan X, et al. Detecting the skewness of data from the sample size and the five-number summary. arXiv [stat.ME]. Available at: https:\/\/doi.org\/10.48550\/arXiv.2019.05749. Accessed June 16, 2022."},{"key":"10.1053\/j.jvca.2023.03.018_bib0034","first-page":"e088","article-title":"Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults","volume":"2","author":"Delgado","year":"2018","journal-title":"J Am Acad Orthop Surg Glob Res Rev"},{"key":"10.1053\/j.jvca.2023.03.018_bib0035","doi-asserted-by":"crossref","first-page":"e76654","DOI":"10.1371\/journal.pone.0076654","article-title":"Graphical tools for network meta-analysis in STATA","volume":"8","author":"Chaimani","year":"2013","journal-title":"PLoS One"},{"key":"10.1053\/j.jvca.2023.03.018_bib0036","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1213\/ANE.0000000000004061","article-title":"Methylprednisolone does not reduce acute postoperative pain after cardiac surgery: Subanalysis of a randomized clinical trial","volume":"129","author":"Turan","year":"2019","journal-title":"Anesth Analg"},{"key":"10.1053\/j.jvca.2023.03.018_bib0037","first-page":"509","article-title":"The dose-dependent effects of ketoprofen on dynamic pain after open heart surgery","volume":"20","author":"Eljezi","year":"2017","journal-title":"Pain Physician"},{"key":"10.1053\/j.jvca.2023.03.018_bib0038","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.jescts.2018.11.003","article-title":"A comparative study of preemptive effect of pregabalin and gabapentin on postoperative pain after coronary artery bypass graft surgery. A clinical randomized trial","volume":"26","author":"Hanoura","year":"2018","journal-title":"J Egypt Soc Cardio-Thorac Surg"},{"key":"10.1053\/j.jvca.2023.03.018_bib0039","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1053\/j.jvca.2016.02.010","article-title":"Intravenous acetaminophen as an adjunct analgesic in cardiac surgery reduces opioid consumption but not opioid-related adverse effects: A randomized controlled trial","volume":"30","author":"Jelacic","year":"2016","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"10.1053\/j.jvca.2023.03.018_bib0040","doi-asserted-by":"crossref","DOI":"10.1016\/j.jtcvs.2016.04.078","article-title":"Intravenous acetaminophen analgesia after cardiac surgery: A randomized, blinded, controlled superiority trial","volume":"152","author":"Mamoun","year":"2016","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1053\/j.jvca.2023.03.018_bib0041","doi-asserted-by":"crossref","first-page":"404","DOI":"10.21470\/1678-9741-2017-0253","article-title":"The effect of dexmedetomidine on the acute pain after cardiothoracic surgeries: A systematic review","volume":"33","author":"Habibi","year":"2018","journal-title":"Braz J Cardiovasc Surg"},{"key":"10.1053\/j.jvca.2023.03.018_bib0042","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1097\/ALN.0b013e318297630d","article-title":"Perioperative systemic magnesium to minimize postoperative pain: A meta-analysis of randomized controlled trials","volume":"119","author":"De Oliveira","year":"2013","journal-title":"Anesthesiology"},{"key":"10.1053\/j.jvca.2023.03.018_bib0043","article-title":"Oral pregabalin in cardiac surgery: A systematic review and meta-analysis of randomized controlled trials","volume":"2021","author":"Wang","year":"2021","journal-title":"Biomed Res Int"},{"key":"10.1053\/j.jvca.2023.03.018_bib0044","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/j.bja.2022.06.020","article-title":"Outcomes of dexmedetomidine versus propofol sedation in critically ill adults requiring mechanical ventilation: A systematic review and meta-analysis of randomised controlled trials","volume":"129","author":"Heybati","year":"2022","journal-title":"Br J Anaesth"},{"key":"10.1053\/j.jvca.2023.03.018_bib0045","article-title":"Alpha-2 adrenergic agonists for the prevention of cardiac complications among adults undergoing surgery","volume":"3","author":"Duncan","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1053\/j.jvca.2023.03.018_bib0046","doi-asserted-by":"crossref","first-page":"202","DOI":"10.4103\/0971-9784.154478","article-title":"Ketamine in adult cardiac surgery and the cardiac surgery Intensive Care Unit: An evidence-based clinical review","volume":"18","author":"Mazzeffi","year":"2015","journal-title":"Ann Card Anaesth"},{"key":"10.1053\/j.jvca.2023.03.018_bib0047","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1007\/s40140-021-00468-z","article-title":"The use of corticosteroids for cardiopulmonary bypass in adults","volume":"11","author":"Perchermeier","year":"2021","journal-title":"Curr Anesthesiol Rep"},{"key":"10.1053\/j.jvca.2023.03.018_bib0048","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/j.bja.2017.10.025","article-title":"Steroids in cardiac surgery: A systematic review and meta-analysis","volume":"120","author":"Dvirnik","year":"2018","journal-title":"Br J Anaesth"}],"container-title":["Journal of Cardiothoracic and Vascular Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S105307702300188X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S105307702300188X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T08:02:09Z","timestamp":1760947329000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S105307702300188X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":48,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["S105307702300188X"],"URL":"https:\/\/doi.org\/10.1053\/j.jvca.2023.03.018","relation":{},"ISSN":["1053-0770"],"issn-type":[{"value":"1053-0770","type":"print"}],"subject":[],"published":{"date-parts":[[2023,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Comparative Efficacy of Adjuvant Nonopioid Analgesia in Adult Cardiac Surgical Patients: A Network Meta-Analysis","name":"articletitle","label":"Article Title"},{"value":"Journal of Cardiothoracic and Vascular Anesthesia","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1053\/j.jvca.2023.03.018","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}