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学科主题: 临床医学
题名:
Thoracic epidural anesthesia improves outcomes in patients undergoing cardiac surgery: meta-analysis of randomized controlled trials
作者: Zhang, Shengsuo1; Wu, Xinmin2; Guo, Hang1; Ma, Li1
关键词: Epidural anesthesia ; Cardiac surgery ; Cardiac function ; Meta-analysis
刊名: EUROPEAN JOURNAL OF MEDICAL RESEARCH
发表日期: 2015-03-15
DOI: 10.1186/s40001-015-0091-y
卷: 20
收录类别: SCI
文章类型: Review
WOS标题词: Science & Technology
类目[WOS]: Medicine, Research & Experimental
研究领域[WOS]: Research & Experimental Medicine
关键词[WOS]: ARTERY-BYPASS-SURGERY ; POSTOPERATIVE MYOCARDIAL-INFARCTION ; CARDIOPULMONARY BYPASS ; GENERAL-ANESTHESIA ; GRAFT-SURGERY ; INFLAMMATORY RESPONSE ; ATRIAL-FIBRILLATION ; CORONARY SURGERY ; PAIN MANAGEMENT ; HOSPITAL STAY
英文摘要:

To assess the efficacy of thoracic epidural anesthesia (TEA) with or without general anesthesia (GA) versus GA in patients who underwent cardiac surgery, PubMed, Embase, the Cochrane online database, and Web of Science were searched with the limit of randomized controlled trials (RCTs) relevant to ′thoracic epidural anesthesia′ and ′cardiac surgery′. Studies were identified and data were extracted by two reviewers independently. The quality of included studies was also assessed according to the Cochrane handbook. Outcomes of mortality, cardiac and respiratory functions, and treatment-associated complications were pooled and analyzed. The comprehensive search yielded 2,230 citations, and 25 of them enrolling 3,062 participants were included according to the inclusion criteria. Compared with GA alone, patients received TEA and GA showed reduced risks of death, myocardial infarction, and stroke, though there were no significant differences (P > 0.05). With regard to treatment-related complications, the pooled results for respiratory complications (risk ratio (RR), 0.69; 95% CI: 0.51, 0.91, P < 0.05), supraventricular arrhythmias (RR, 0.61; 95% CI: 0.42, 0.87, P < 0.05), and pain (mean difference (MD), -1.27; 95% CI: -2.20, -0.35, P < 0.05) were 0.69, 0.61, and -1.27, respectively. TEA was also associated with significant reduction of stays in intensive care unit (MD, -2.36; 95% CI: -4.20, -0.52, P < 0.05) and hospital (MD, -1.51; 95% CI: -3.03, 0.02, P > 0.05) and time to tracheal extubation (MD, -2.06; 95% CI:-2.68, -1.45, P < 0.05). TEA could reduce the risk of complications such as supraventricular arrhythmias, stays in hospital or intensive care unit, and time to tracheal extubation in patients who experienced cardiac surgery.

语种: 英语
WOS记录号: WOS:000351820500001
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55638
Appears in Collections:北京大学第一临床医学院_麻醉科_期刊论文

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作者单位: 1.Beijing Mil Reg PLA, Gen Hosp, Dept Anesthesiol, Beijing 100010, Peoples R China
2.Peking Univ, Hosp 1, Dept Anesthesiol, Beijing 100034, Peoples R China

Recommended Citation:
Zhang, Shengsuo,Wu, Xinmin,Guo, Hang,et al. Thoracic epidural anesthesia improves outcomes in patients undergoing cardiac surgery: meta-analysis of randomized controlled trials[J]. EUROPEAN JOURNAL OF MEDICAL RESEARCH,2015,20.
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