Effects of anesthetic depth on postoperative pain and delirium: a meta-analysis of randomized controlled trials with trial sequential analysis
| Autor: | Yuqin Long, Xiaomei Feng, Hong Liu, Xisheng Shan, Fuhai Ji, Ke Peng |
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| Rok vydání: | 2022 |
| Předmět: |
Adult
Trial sequential analysis Clinical Trials and Supportive Activities 6.3 Medical devices Pain GRADE level of evidence Cardiorespiratory Medicine and Haematology Cardiovascular Postoperative pain Postoperative Complications Emergence Delirium Clinical Research General & Internal Medicine Acquired Cognitive Impairment Humans Anesthesia Oncology & Carcinogenesis Postoperative Anesthetics Randomized Controlled Trials as Topic Other Medical and Health Sciences Pain Research Rehabilitation Neurosciences Postoperative delirium Evaluation of treatments and therapeutic interventions General Medicine Brain Disorders Good Health and Well Being Anesthetic depth Chronic Pain |
| Zdroj: | Chinese medical journal, vol 135, iss 23 |
| Popis: | BackgroundWhether anesthetic depth affects postoperative outcomes remains controversial. This meta-analysis aimed to evaluate the effects of deep vs. light anesthesia on postoperative pain, cognitive function, recovery from anesthesia, complications, and mortality.MethodsPubMed, EMBASE, and Cochrane CENTRAL databases were searched until January 2022 for randomized controlled trials comparing deep and light anesthesia in adult surgical patients. The co-primary outcomes were postoperative pain and delirium (assessed using the confusion assessment method). We conducted a meta-analysis using a random-effects model. We assessed publication bias using the Begg's rank correlation test and Egger's linear regression. We evaluated the evidence using the trial sequential analysis and Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. We conducted subgroup analyses for pain scores at different postoperative time points and delirium according to cardiac or non-cardiac surgery.ResultsA total of 26 trials with 10,743 patients were included. Deep anesthesia compared with light anesthesia (a mean difference in bispectral index of -12 to -11) was associated with lower pain scores at rest at 0 to 1 h postoperatively (weighted mean difference = -0.72, 95% confidence interval [CI] = -1.25 to -0.18, P = 0.009; moderate-quality evidence) and an increased incidence of postoperative delirium (24.95% vs. 15.92%; risk ratio = 1.57, 95% CI = 1.28-1.91, P |
| Databáze: | OpenAIRE |
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