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    Please use this identifier to cite or link to this item: https://ir.cnu.edu.tw/handle/310902800/34531


    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
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