Yuan Tao, Yang Wenming, Yang Lei, Liu Xueting, Yang Lie, Li Yu
Department of Anesthesiology.
Translational Neuroscience Center, Laboratory of Anesthesia and Critical Care Medicine.
Medicine (Baltimore). 2020 Aug 14;99(33):e21669. doi: 10.1097/MD.0000000000021669.
Whether regional anesthesia (RA) offers better long-term neurodevelopment outcomes compared to general anesthesia (GA) to infants undergoing inguinal herniorrhaphy is still under heated debate. The aim of this meta-analysis is to compare the long-term neurodevelopment impact of RA with GA on infants undergoing inguinal herniorrhaphy.
A systematic search of MEDLINE, EMBASE, PubMed, the Cochrane Central Register of Controlled Trials, clinicaltrials.gov and controlledtrials.com will be performed. Published eligible randomized controlled trials (RCTs) or quasi-RCTs (including abstracts) through May 20, 2020 with language limit of English will be enrolled in the meta-analysis. Two reviewers will independently conduct the procedures of study selection, data extraction, methodological quality assessment, and risk of bias assessment. The primary outcome is long-term neurodevelopmental state (at 2- and 5-year follow-up) as reflected in the Bayley and the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) scales of infants development following surgeries. The secondary outcomes consist of satisfactory intraoperative infants immobility, duration of surgery, any anesthetic failure, the supplement of postoperative analgesia, postoperative apnea, and postoperative bradycardia. The pooled weighted mean differences (WMDs) or odds ratios (ORs) of each outcome measurement and relative 95% confident intervals (CIs) will be calculated. EndNote X8 (Clarivate Analytics) software will be applied to manage all citations. The Cochrane Review Manager version 5.3 software (RevMan 5.3) will be employed for statistical analysis.
This study will summarize scientific and practical evidence and provide evidence-based individualized decision-making guidance on anesthesia regimen for inguinal herniorrhaphy in infants.
This protocol was registered with the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) on 17 June 2020 (registration number INPLASY202060064).
对于接受腹股沟疝修补术的婴儿，区域麻醉（RA）与全身麻醉（GA）相比是否能带来更好的长期神经发育结局仍在激烈争论中。本荟萃分析的目的是比较RA与GA对接受腹股沟疝修补术婴儿的长期神经发育影响。
将对MEDLINE、EMBASE、PubMed、Cochrane对照试验中央注册库、clinicaltrials.gov和controlledtrials.com进行系统检索。纳入截至2020年5月20日发表的符合条件的随机对照试验（RCT）或半随机对照试验（包括摘要），语言限制为英语，纳入荟萃分析。两名研究者将独立进行研究选择、数据提取、方法学质量评估和偏倚风险评估。主要结局是手术后婴儿发育的贝利量表和韦氏学龄前及初小儿童智力量表（WPPSI）所反映的长期神经发育状态（在2年和5年随访时）。次要结局包括术中婴儿安静满意、手术时间、任何麻醉失败、术后镇痛补充、术后呼吸暂停和术后心动过缓。将计算每个结局指标的合并加权平均差（WMD）或比值比（OR）以及相对95%置信区间（CI）。将应用EndNote X8（科睿唯安分析公司）软件管理所有文献引用。将使用Cochrane系统评价管理器5.3版软件（RevMan 5.3）进行统计分析。
本研究将总结科学和实践证据，并为婴儿腹股沟疝修补术的麻醉方案提供基于证据的个体化决策指导。
本方案于2020年6月17日在国际注册系统评价和荟萃分析方案平台（INPLASY）注册（注册号INPLASY202060064）。
