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全身麻醉不会导致成人术后长期认知功能障碍：一项荟萃分析。

General anaesthesia does not contribute to long-term post-operative cognitive dysfunction in adults: A meta-analysis.

作者信息

Guay Joanne

机构信息

Department of Anesthesiology, University of Montreal, Montreal, Quebec, Canada.

出版信息

Indian J Anaesth. 2011 Jul;55(4):358-63. doi: 10.4103/0019-5049.84850.

DOI:10.4103/0019-5049.84850
PMID:22013251
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3190509/
Abstract

CONTEXT

The contribution of anaesthesia itself to post-operative cognitive dysfunction (POCD) or the potential protective effect of one specific type of anaesthesia on the occurrence of POCD is unclear.

AIMS

This is a meta-analysis evaluating the effects of the anaesthetic technique (regional vs. general anaesthesia) on POCD of patients undergoing non-cardiac surgery.

SETTINGS AND DESIGN

Meta-analysis performed in a University affiliated hospital.

METHODS

A search for randomized controlled trials (RCT) comparing regional anaesthesia to general anaesthesia for surgery was done in PUBMED, MEDLINE, EMBASE, EBM Reviews-Cochrane Central Register of Controlled Trials, PsychINFO and Current Contents/all editions in 2009.

STATISTICAL ANALYSIS

Data were analyzed with comprehensive Meta-analysis Version 2.2.044.

RESULTS

Twenty-six RCTs including 2365 patients: 1169 for regional anaesthesia and 1196 for general anaesthesia were retained. The standardized difference in means for the tests included in the 26 RCTs was -0.08 (95% confidence interval: -0.17-0.01; P value 0.094; I-squared = 0.00%). The assessor was blinded to the anaesthetic technique for 12 of the RCTs including only 798 patients: 393 for regional anaesthesia and 405 for general anaesthesia. The standardized difference in means for these 12 studies is 0.05 (-0.10-0.20; P=0.51; I-squared = 0.00%).

CONCLUSIONS

The present meta-analysis does not support the concerns that a single exposure to general anaesthesia in an adult would significantly contribute to permanent POCD after non-cardiac surgery.

摘要

背景

麻醉本身对术后认知功能障碍（POCD）的影响，或某一特定类型麻醉对POCD发生的潜在保护作用尚不清楚。

目的

本荟萃分析旨在评估麻醉技术（区域麻醉与全身麻醉）对非心脏手术患者POCD的影响。

设置与设计

在一家大学附属医院进行的荟萃分析。

方法

2009年在PUBMED、MEDLINE、EMBASE、循证医学评价-考克兰对照试验中心注册库、心理学文摘数据库以及最新目次/所有版本中检索比较区域麻醉与全身麻醉用于手术的随机对照试验（RCT）。

统计分析

采用综合荟萃分析2.2.044版对数据进行分析。

结果

纳入26项RCT，共2365例患者，其中区域麻醉组1169例，全身麻醉组1196例。26项RCT纳入试验的标准化均数差为-0.08（95%置信区间：-0.17 - 0.01；P值0.094；I² = 0.00%）。12项RCT的评估者对麻醉技术不知情，仅包括798例患者，其中区域麻醉组393例，全身麻醉组405例。这12项研究的标准化均数差为0.05（-0.10 - 0.20；P = 0.51；I² = 0.00%）。

结论

本荟萃分析不支持下述担忧，即成人单次接受全身麻醉会显著导致非心脏手术后永久性POCD。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8711/3190509/7aaf500ff227/IJA-55-358-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8711/3190509/f77c73cdf57f/IJA-55-358-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8711/3190509/f1597fb6e558/IJA-55-358-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8711/3190509/9d4c8371b83c/IJA-55-358-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8711/3190509/7aaf500ff227/IJA-55-358-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8711/3190509/f77c73cdf57f/IJA-55-358-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8711/3190509/f1597fb6e558/IJA-55-358-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8711/3190509/9d4c8371b83c/IJA-55-358-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8711/3190509/7aaf500ff227/IJA-55-358-g005.jpg

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