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| 標題: | Impact of combined epidural anaesthesia/analgesia on postoperative cognitive impairment in patients receiving general anaesthesia: a meta-analysis of randomised controlled studies |
| 作者: | Teng, I-Chia
Sun, Cheuk-Kwan
Ho, Chun-Ning
Wang, Li-Kai
Lin, Yao-Tsung
Chen, Ying-Jen
Chin, Jen-Yin
Chu, Chin-Chen
Hsing, Chung-Hsi
Hung, Kuo-Chuan |
| 貢獻者: | Chi Mei Hospital
E-Da Hospital
I Shou University
Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy & Science
Department of Recreation and Health-Care Management, Chia Nan University of Pharmacy & Science |
| 關鍵字: | intraoperative hypotension
risk-factors
controlled analgesia
elderly-patients
delirium
surgery
dysfunction
outcomes
reduction |
| 日期: | 2022 |
| 上傳時間: | 2023-12-11 13:56:18 (UTC+8) |
| 出版者: | ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER |
| 摘要: | Background: To investigate the efficacy of combined epidural anaesthesia/analgesia (EAA) against postoperative delirium/cognitive dysfunction (POD/POCD) in adults after major non-cardiac surgery under general anaesthesia (GA). Methods: The databases of PubMed, Google Scholar, Embase and Cochrane Central Register were searched from inception to November 2021 for available randomised controlled trials (RCTs) that assessed the impact of EAA on risk of POD/POCD. The primary outcome was risk of POD/POCD, while the secondary outcomes comprised postoperative pain score, length of hospital stay (LOS), risk of complications, and postoperative nausea/vomiting (PONV). Results: Meta-analysis of eight studies with a total of 2376 patients (EAA group: 1189 patients; non-EAA group: 1187 patients) revealed no difference in risk of POD/POCD between the EAA and the non-EAA groups [Risk ratio (RR): 0.68; 95% CI: 0.41 to 1.13, p = 0.14, I-2 = 73%], but the certainty of evidence was very low. Nevertheless, the EAA group had lower pain score at postoperative 24 h [mean difference (MD): -1.49, 95% CI: -2.38 to -0.61; I-2 = 98%; five RCTs; n = 476] and risk of PONV (RR = 0.73, 95% CI: 0.57 to 0.93, p = 0.01, I-2 = 0%; three RCTs, 1876 patients) than those in the non-EAA group. Our results showed no significant impact of EAA on the pain score at postoperative 36-72 h, LOS, and risk of complications. Conclusion: This meta-analysis demonstrated that EAA had no significant impact on the incidence of POD/POCD in patients following non-cardiac surgery. (c) 2022 Societe francaise d'anesthesie et de reanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved. |
| 關聯: | Anaesthesia Critical Care & Pain Medicine, v.41, Issue 5, October 2022, 101119 |
| 顯示於類別: | [醫務管理系(所)] 期刊論文
[休閒保健管理系(所)] 期刊論文
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