PMID: 15220785Jun 29, 2004Paper

Effects of perioperative central neuraxial analgesia on outcome after coronary artery bypass surgery: a meta-analysis

Anesthesiology
Spencer S LiuChristopher L Wu

Abstract

Perioperative central neuraxial analgesia may improve outcome after coronary artery bypass surgery due to attenuation of stress response and superior analgesia. MEDLINE and other databases were searched for randomized controlled trials in patients undergoing coronary artery bypass surgery with cardiopulmonary bypass who were randomized to either general anesthesia (GA) versus general anesthesia-thoracic epidural analgesia (TEA) or general anesthesia-intrathecal analgesia (IT). Fifteen trials enrolling 1178 patients were included for TEA analysis. TEA did not affect incidences of mortality (0.7% TEA vs. 0.3% GA) or myocardial infarction (2.3% TEA vs. 3.4% GA). TEA significantly reduced the risk of dysrhythmias with an odds ratio of 0.52, pulmonary complications with an odds ratio of 0.41, and time to tracheal extubation by 4.5 h and reduced analog pain scores at rest by 7.8 mm and with activity by 11.6 mm. Seventeen trials enrolling 668 patients were included for IT analysis. IT had no significant effect on incidences of mortality (0.3% IT vs. 0.6% GA), myocardial infarction (3.9% IT vs. 5.7% GA), dysrhythmias (24.8% vs. 29.1%), nausea/vomiting (31.3% vs. 28.5%), or time to tracheal extubation (10.4 h IT vs. 10.9 h GA). IT modes...Continue Reading

References

Apr 1, 1992·Journal of Cardiothoracic and Vascular Anesthesia·T H LiemM J Gielen
Jan 1, 1989·Acta Anaesthesiologica Scandinavica. Supplementum·P F NiedererD R Spahn
Mar 1, 1988·Anesthesia and Analgesia·G S VanstrumR Ilko
May 1, 1988·British Journal of Anaesthesia·G J Fitzpatrick, D C Moriarty
Oct 1, 1995·British Journal of Anaesthesia·C M MooreG M Hall
Nov 1, 1994·Journal of the American Medical Informatics Association : JAMIA·R B HaynesJ C Sinclair
Nov 1, 1994·Acta Anaesthesiologica Scandinavica·R StensethS E Gisvold
Aug 1, 1996·Anesthesia and Analgesia·M A ChaneyS Slogoff
Jan 1, 1996·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·R StensethS E Gisvold
Feb 1, 1997·Anesthesia and Analgesia·M A ChaneyS Slogoff
Jun 1, 1997·Anesthesia and Analgesia·M A Chaney
Sep 24, 1999·JAMA : the Journal of the American Medical Association·P JüniM Egger
Oct 20, 1999·Journal of Cardiothoracic and Vascular Anesthesia·M A ChaneyM Bakhos
Mar 29, 2000·The Annals of Thoracic Surgery·M CarrierL C Pelletier
Jun 1, 2000·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·R HallR McLaren
Aug 10, 2000·Anesthesiology Clinics of North America·J A Grass
Jan 4, 2001·Journal of Cardiothoracic and Vascular Anesthesia·J A AlhashemiD Boyd
Jan 4, 2001·Journal of Cardiothoracic and Vascular Anesthesia·F E RalleyD C Cheng
Jul 24, 2001·The Annals of Thoracic Surgery·L JidéusC Blomström-Lundqvist
Feb 21, 2002·Journal of Cardiothoracic and Vascular Anesthesia·Mary P FillingerD David Glass
Aug 24, 2002·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Dominique A BettexEdith R Schmid
Aug 28, 2002·The Annals of Pharmacotherapy·Aline BoulangerClaude Laflamme
Oct 31, 2002·Journal of Cardiothoracic and Vascular Anesthesia·Alexandre YazigiGemma Hayek
Dec 18, 2002·Journal of Cardiothoracic and Vascular Anesthesia·Ian BowlerJudith Hall
Jan 23, 2003·The Annals of Thoracic Surgery·Colin RoyseJenny Pang
Feb 21, 2003·British Journal of Anaesthesia·P LenaF Bonnet
Sep 26, 2003·Anesthesiology·Paul S MylesDavy C H Cheng

❮ Previous
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Citations

Jun 21, 2008·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Paul K TenenbeinStephen E Kowalski
Sep 29, 2005·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Mark A Chaney
Apr 26, 2006·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Daniel BainbridgeDavy C Cheng
Jan 22, 2009·Der Anaesthesist·H L Rittner, A Brack
Jan 12, 2010·Der Anaesthesist·P M SpiethM Gama de Abreu
Nov 24, 2011·Der Anaesthesist·M DammA R Heller
Jun 19, 2012·British Journal of Anaesthesia·A GottschalkH-J Schulze
Apr 26, 2012·Regional Anesthesia and Pain Medicine·Narinder Rawal
Jun 17, 2008·Critical Care : the Official Journal of the Critical Care Forum·Diederik Gommers, Jan Bakker
Dec 22, 2005·Anesthesia and Analgesia·Mark A Chaney
Nov 24, 2006·Anesthesia and Analgesia·Thomas M HemmerlingJohn P Williams
May 4, 2010·Anesthesia and Analgesia·Antje GottschalkMohamed Tiouririne
Jan 12, 2008·The Heart Surgery Forum·David BraccoUNKNOWN PeriCARG Group, Montréal
Sep 2, 2011·Acta chirurgica Iugoslavica·Ana MandraNevena Kalezić
Jan 13, 2009·Annals of Cardiac Anaesthesia·Chaitali SendasguptaSambhu N Das
Jul 3, 2013·Annals of Cardiac Anaesthesia·Thomas M HemmerlingNora Terrasini
Mar 31, 2009·Annales Françaises D'anesthèsie Et De Rèanimation·D Fletcher, C Jayr
Jun 3, 2014·World Journal of Surgical Oncology·Gonul SagirogluSerhat Huseyin
Mar 30, 2010·Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række·Terje VeelHilde Pleym
Jul 10, 2012·Acta Anaesthesiologica Taiwanica : Official Journal of the Taiwan Society of Anesthesiologists·Chien-Chung HuangChia-Shiang Lin
Jul 16, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Dominik LinzHans-Ruprecht Neuberger
Nov 14, 2007·Chest·Srinivas R BapojeRichard K Albert
Jun 5, 2012·Revista española de anestesiología y reanimación·P CarmonaJ de Andrés
Dec 14, 2011·Journal of Cardiothoracic and Vascular Anesthesia·Menachem M WeinerAlexander J C Mittnacht
Oct 1, 2011·Journal of Cardiothoracic and Vascular Anesthesia·Michael Mazzeffi, Yury Khelemsky
May 31, 2011·Anesthesiology Clinics·Kishor GandhiEugene R Viscusi
Jun 12, 2010·Journal of Cardiothoracic and Vascular Anesthesia·Nicholas B Scott
Dec 17, 2009·Journal of Cardiothoracic and Vascular Anesthesia·Elena BignamiAlberto Zangrillo
Oct 6, 2009·Journal of Cardiothoracic and Vascular Anesthesia·Alberto ZangrilloGiovanni Landoni
Jul 10, 2009·Cirugía española·María Teresa Santeularia VergésMaría Victoria Moral García
Sep 4, 2008·Anesthesiology Clinics·Alex KonstantatosPaul S Myles
Jul 30, 2008·Journal of Cardiothoracic and Vascular Anesthesia·Pierre LenaFrancis Bonnet

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