{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T22:17:04Z","timestamp":1791584224937,"version":"4.3.4"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Morphine\u2010sparing effects are often used to evaluate non\u2010opioid analgesic interventions. The exact effect that would warrant the implementation of these interventions in clinical practice (a minimally important difference) remains unclear. We aimed to determine this with anchor\u2010based methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a post hoc analysis of three studies investigating pain management after hip or knee arthroplasty (PANSAID [NCT02571361], DEX\u20102\u2010TKA [NCT03506789] and Pain Map [NCT02340052]). The overall population was median aged 70, median ASA 2, 54% female. We examined the correlation between 0 and 24\u2009h postoperative iv morphine equivalent consumption and the severity of nausea, vomiting, sedation and dizziness. The anchor was different severity degrees of these opioid\u2010related adverse events. The primary outcome was the difference in morphine consumption between patients experiencing <jats:italic>no<\/jats:italic> versus <jats:italic>only mild<\/jats:italic> events. Secondary outcomes included the difference in morphine consumption between patients with <jats:italic>mild<\/jats:italic> versus <jats:italic>moderate<\/jats:italic> and <jats:italic>moderate<\/jats:italic> versus <jats:italic>severe<\/jats:italic> events. We used Hodges\u2013Lehmann median differences, exact Wilcoxon\u2013Mann\u2013Whitney tests and quantile regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The difference in iv morphine consumption was 6\u2009mg (95% confidence interval: 4\u20138) between patients with <jats:italic>no<\/jats:italic> versus <jats:italic>only mild<\/jats:italic> events, 5\u2009mg (2\u20138) between patients with <jats:italic>mild<\/jats:italic> versus <jats:italic>moderate<\/jats:italic> events and 0\u2009mg (\u22124 to 4) between patients with <jats:italic>moderate<\/jats:italic> versus <jats:italic>severe<\/jats:italic> events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In populations comparable to this post\u2010hoc analysis (orthopaedic surgery, median age 70 and ASA 2), we suggest a minimally important difference of 5\u2009mg for 0\u201324\u2009h postoperative iv morphine consumption.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14388","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T08:57:33Z","timestamp":1708505853000},"page":"610-618","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Minimal important difference in postoperative morphine consumption after hip and knee arthroplasty using nausea, vomiting, sedation and dizziness as anchors"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0338-3751","authenticated-orcid":false,"given":"Anders Peder H\u00f8jer","family":"Karlsen","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Bispebjerg and Frederiksberg Hospitals  Copenhagen Denmark"},{"name":"Centre for Anaesthesiological Research, Department of Anaesthesiology Zealand University Hospital  Koege Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5297-3769","authenticated-orcid":false,"given":"Jens","family":"Laigaard","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Traumatology Bispebjerg Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3531-8161","authenticated-orcid":false,"given":"Casper","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Centre for Anaesthesiological Research, Department of Anaesthesiology Zealand University Hospital  Koege Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4727-3132","authenticated-orcid":false,"given":"Kasper H\u00f8jgaard","family":"Thybo","sequence":"additional","affiliation":[{"name":"Centre for Anaesthesiological Research, Department of Anaesthesiology Zealand University Hospital  Koege Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1484-483X","authenticated-orcid":false,"given":"Kasper Smidt","family":"Gasbjerg","sequence":"additional","affiliation":[{"name":"Centre for Anaesthesiological Research, Department of Anaesthesiology Zealand University Hospital  Koege Denmark"},{"name":"Research Centre of Anaesthesiology and Intensive Care Medicine, Department of Anaesthesiology N\u00e6stved\u2010Slagelse\u2010Ringsted Hospitals  Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2461-2672","authenticated-orcid":false,"given":"Anja","family":"Geisler","sequence":"additional","affiliation":[{"name":"Centre for Anaesthesiological Research, Department of Anaesthesiology Zealand University Hospital  Koege Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Troels Haxholdt","family":"Lunn","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Bispebjerg and Frederiksberg Hospitals  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8008-6614","authenticated-orcid":false,"given":"Daniel","family":"H\u00e4gi\u2010Pedersen","sequence":"additional","affiliation":[{"name":"Research Centre of Anaesthesiology and Intensive Care Medicine, Department of Anaesthesiology N\u00e6stved\u2010Slagelse\u2010Ringsted Hospitals  Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3642-2120","authenticated-orcid":false,"given":"Janus Christian","family":"Jakobsen","sequence":"additional","affiliation":[{"name":"Department of Regional Health Research, The Faculty of Health Sciences University of Southern Denmark  Denmark"},{"name":"Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet Copenhagen University Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4544-0619","authenticated-orcid":false,"given":"Ole","family":"Mathiesen","sequence":"additional","affiliation":[{"name":"Centre for Anaesthesiological Research, Department of Anaesthesiology Zealand University Hospital  Koege Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,21]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-200102000-00022"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30428-3"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30352-6"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20150701-61"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2008\/11\/S105"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2013.09.074"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15118"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S131979"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002458"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2020-101670"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2021.01.021"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1714"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2003.11.001"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002007"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.22039"},{"key":"e_1_2_12_17_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2021-067325","article-title":"Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial","volume":"376","author":"Gasbjerg KS","year":"2022","journal-title":"BMJ"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.13349"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.14175"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-017-2203-1"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.13481"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1972.10481279"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1198\/000313006X118430"},{"key":"e_1_2_12_24_1","volume-title":"R: a language and environment for statistical computing","author":"R Core Team","year":"2013"},{"key":"e_1_2_12_25_1","volume-title":"Stata Statistical Software: Release 17","author":"StataCorp","year":"2021"},{"key":"e_1_2_12_26_1","unstructured":"JostSD.DePaul University College of Computing and Digital Media.https:\/\/condor.depaul.edu\/sjost\/lsp121\/documents\/boxplots.htm"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.0898"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1080\/17453674.2019.1683790"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2021-102750"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9113747"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10571-020-01013-y"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n2321"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000003887"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.13685"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31821ae3f7"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.18.3.205"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2018.05.007"}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.14388","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T10:30:21Z","timestamp":1713349821000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aas.14388"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,21]]},"references-count":36,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/aas.14388"],"URL":"https:\/\/doi.org\/10.1111\/aas.14388","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"value":"0001-5172","type":"print"},{"value":"1399-6576","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,21]]},"assertion":[{"value":"2023-09-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}