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学科主题临床医学
Thoracic epidural anesthesia improves outcomes in patients undergoing cardiac surgery: meta-analysis of randomized controlled trials
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
2015-03-15
DOI10.1186/s40001-015-0091-y
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
引用统计
被引频次:5[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/55638
专题北京大学第一临床医学院_麻醉科
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
推荐引用方式
GB/T 7714
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.
APA Zhang, Shengsuo,Wu, Xinmin,Guo, Hang,&Ma, Li.(2015).Thoracic epidural anesthesia improves outcomes in patients undergoing cardiac surgery: meta-analysis of randomized controlled trials.EUROPEAN JOURNAL OF MEDICAL RESEARCH,20.
MLA Zhang, Shengsuo,et al."Thoracic epidural anesthesia improves outcomes in patients undergoing cardiac surgery: meta-analysis of randomized controlled trials".EUROPEAN JOURNAL OF MEDICAL RESEARCH 20(2015).
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