Effectiveness of combined regional-general anesthesia for reducing mortality in coronary artery bypass: meta-analysis
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista Brasileira de Anestesiologia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942016000200183 |
Resumo: | ABSTRACT BACKGROUND AND OBJECTIVES: Neuraxial anesthesia (NA) has been used in association with general anesthesia (GA) for coronary artery bypass; however, anticoagulation during surgery makes us question the viability of benefits by the risk of epidural hematoma. The aim of this study was to perform a meta-analyzes examining the efficacy of NA associated with GA compared to GA alone for coronary artery bypass on mortality reduction. METHODS: Mortality, arrhythmias, cerebrovascular accident (CVA), myocardial infarction (MI), length of hospital stay (LHS), length of ICU stay (ICUS), reoperations, blood transfusion (BT), quality of life, satisfaction degree, and postoperative cognitive dysfunction were analyzed. The weighted mean difference (MD) was estimated for continuous variables, and relative risk (RR) and risk difference (RD) for categorical variables. RESULTS: 17 original articles analyzed. Meta-analysis of mortality (RD = -0.01, 95% CI = -0.03 to 0.01), CVA (RR = 0.79, 95% CI = 0.32-1.95), MI (RR = 0.96, 95% CI = 0.52-1.79) and LHS (MD = -1.94, 95% CI = -3.99 to 0.12) were not statistically significant. Arrhythmia was less frequent with NA (RR = 0.68, 95% CI = 0.50-0.93). ICUS was lower in NA (MD = -2.09, 95% CI = -2.92 to -1.26). CONCLUSION: There was no significant difference in mortality. Combined NA and GA showed lower incidence of arrhythmias and lower ICUS. |
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Revista Brasileira de Anestesiologia (Online) |
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Effectiveness of combined regional-general anesthesia for reducing mortality in coronary artery bypass: meta-analysisGeneral anesthesiaNeuraxial anesthesiaMortalityMeta-analysisCoronary artery bypassABSTRACT BACKGROUND AND OBJECTIVES: Neuraxial anesthesia (NA) has been used in association with general anesthesia (GA) for coronary artery bypass; however, anticoagulation during surgery makes us question the viability of benefits by the risk of epidural hematoma. The aim of this study was to perform a meta-analyzes examining the efficacy of NA associated with GA compared to GA alone for coronary artery bypass on mortality reduction. METHODS: Mortality, arrhythmias, cerebrovascular accident (CVA), myocardial infarction (MI), length of hospital stay (LHS), length of ICU stay (ICUS), reoperations, blood transfusion (BT), quality of life, satisfaction degree, and postoperative cognitive dysfunction were analyzed. The weighted mean difference (MD) was estimated for continuous variables, and relative risk (RR) and risk difference (RD) for categorical variables. RESULTS: 17 original articles analyzed. Meta-analysis of mortality (RD = -0.01, 95% CI = -0.03 to 0.01), CVA (RR = 0.79, 95% CI = 0.32-1.95), MI (RR = 0.96, 95% CI = 0.52-1.79) and LHS (MD = -1.94, 95% CI = -3.99 to 0.12) were not statistically significant. Arrhythmia was less frequent with NA (RR = 0.68, 95% CI = 0.50-0.93). ICUS was lower in NA (MD = -2.09, 95% CI = -2.92 to -1.26). CONCLUSION: There was no significant difference in mortality. Combined NA and GA showed lower incidence of arrhythmias and lower ICUS.Sociedade Brasileira de Anestesiologia2016-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942016000200183Revista Brasileira de Anestesiologia v.66 n.2 2016reponame:Revista Brasileira de Anestesiologia (Online)instname:Sociedade Brasileira de Anestesiologia (SBA)instacron:SBA10.1016/j.bjane.2014.05.012info:eu-repo/semantics/openAccessBarbosa,Fabiano TimbóCunha,Rafael Martins daRamos,Fernando Wagner da SilvaLima,Fernando José Camello deRodrigues,Amanda Karine BarrosGalvão,Ailton Mota do NascimentoSousa-Rodrigues,Célio Fernando deLima,Paula Monique Barbosaeng2016-03-29T00:00:00Zoai:scielo:S0034-70942016000200183Revistahttps://www.sbahq.org/revista/https://old.scielo.br/oai/scielo-oai.php||sba2000@openlink.com.br1806-907X0034-7094opendoar:2016-03-29T00:00Revista Brasileira de Anestesiologia (Online) - Sociedade Brasileira de Anestesiologia (SBA)false |
dc.title.none.fl_str_mv |
Effectiveness of combined regional-general anesthesia for reducing mortality in coronary artery bypass: meta-analysis |
title |
Effectiveness of combined regional-general anesthesia for reducing mortality in coronary artery bypass: meta-analysis |
spellingShingle |
Effectiveness of combined regional-general anesthesia for reducing mortality in coronary artery bypass: meta-analysis Barbosa,Fabiano Timbó General anesthesia Neuraxial anesthesia Mortality Meta-analysis Coronary artery bypass |
title_short |
Effectiveness of combined regional-general anesthesia for reducing mortality in coronary artery bypass: meta-analysis |
title_full |
Effectiveness of combined regional-general anesthesia for reducing mortality in coronary artery bypass: meta-analysis |
title_fullStr |
Effectiveness of combined regional-general anesthesia for reducing mortality in coronary artery bypass: meta-analysis |
title_full_unstemmed |
Effectiveness of combined regional-general anesthesia for reducing mortality in coronary artery bypass: meta-analysis |
title_sort |
Effectiveness of combined regional-general anesthesia for reducing mortality in coronary artery bypass: meta-analysis |
author |
Barbosa,Fabiano Timbó |
author_facet |
Barbosa,Fabiano Timbó Cunha,Rafael Martins da Ramos,Fernando Wagner da Silva Lima,Fernando José Camello de Rodrigues,Amanda Karine Barros Galvão,Ailton Mota do Nascimento Sousa-Rodrigues,Célio Fernando de Lima,Paula Monique Barbosa |
author_role |
author |
author2 |
Cunha,Rafael Martins da Ramos,Fernando Wagner da Silva Lima,Fernando José Camello de Rodrigues,Amanda Karine Barros Galvão,Ailton Mota do Nascimento Sousa-Rodrigues,Célio Fernando de Lima,Paula Monique Barbosa |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Barbosa,Fabiano Timbó Cunha,Rafael Martins da Ramos,Fernando Wagner da Silva Lima,Fernando José Camello de Rodrigues,Amanda Karine Barros Galvão,Ailton Mota do Nascimento Sousa-Rodrigues,Célio Fernando de Lima,Paula Monique Barbosa |
dc.subject.por.fl_str_mv |
General anesthesia Neuraxial anesthesia Mortality Meta-analysis Coronary artery bypass |
topic |
General anesthesia Neuraxial anesthesia Mortality Meta-analysis Coronary artery bypass |
description |
ABSTRACT BACKGROUND AND OBJECTIVES: Neuraxial anesthesia (NA) has been used in association with general anesthesia (GA) for coronary artery bypass; however, anticoagulation during surgery makes us question the viability of benefits by the risk of epidural hematoma. The aim of this study was to perform a meta-analyzes examining the efficacy of NA associated with GA compared to GA alone for coronary artery bypass on mortality reduction. METHODS: Mortality, arrhythmias, cerebrovascular accident (CVA), myocardial infarction (MI), length of hospital stay (LHS), length of ICU stay (ICUS), reoperations, blood transfusion (BT), quality of life, satisfaction degree, and postoperative cognitive dysfunction were analyzed. The weighted mean difference (MD) was estimated for continuous variables, and relative risk (RR) and risk difference (RD) for categorical variables. RESULTS: 17 original articles analyzed. Meta-analysis of mortality (RD = -0.01, 95% CI = -0.03 to 0.01), CVA (RR = 0.79, 95% CI = 0.32-1.95), MI (RR = 0.96, 95% CI = 0.52-1.79) and LHS (MD = -1.94, 95% CI = -3.99 to 0.12) were not statistically significant. Arrhythmia was less frequent with NA (RR = 0.68, 95% CI = 0.50-0.93). ICUS was lower in NA (MD = -2.09, 95% CI = -2.92 to -1.26). CONCLUSION: There was no significant difference in mortality. Combined NA and GA showed lower incidence of arrhythmias and lower ICUS. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-04-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942016000200183 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942016000200183 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1016/j.bjane.2014.05.012 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Anestesiologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Anestesiologia |
dc.source.none.fl_str_mv |
Revista Brasileira de Anestesiologia v.66 n.2 2016 reponame:Revista Brasileira de Anestesiologia (Online) instname:Sociedade Brasileira de Anestesiologia (SBA) instacron:SBA |
instname_str |
Sociedade Brasileira de Anestesiologia (SBA) |
instacron_str |
SBA |
institution |
SBA |
reponame_str |
Revista Brasileira de Anestesiologia (Online) |
collection |
Revista Brasileira de Anestesiologia (Online) |
repository.name.fl_str_mv |
Revista Brasileira de Anestesiologia (Online) - Sociedade Brasileira de Anestesiologia (SBA) |
repository.mail.fl_str_mv |
||sba2000@openlink.com.br |
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1752126628660510720 |