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首页> 外文期刊>Sao Paulo Medical Journal >Neuraxial anesthesia versus general anesthesia for urological surgery: systematic review
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Neuraxial anesthesia versus general anesthesia for urological surgery: systematic review

机译：神经外科麻醉与全身麻醉在泌尿外科的应用：系统评价

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CONTEXT AND OBJECTIVE Choosing the best anesthetic technique for urological surgery with the aim of mortality reduction remains controversial. The objective here was to compare the effectiveness and safety of neuraxial anesthesia versus general anesthesia for urological surgery. DESIGN AND SETTING Systematic review, Universidade Federal de Alagoas. METHODS We searched the Cochrane Central Register of Controlled Trials in the Cochrane Library (Issue 10, 2012), Medline via PubMed (1966 to October 2012), Lilacs (1982 to October 2012), SciELO and EMBASE (1974 to October 2012). The reference lists of the studies included and of one systematic review in the same field were also analyzed. The studies included were randomized controlled trials (RCT) that analyzed neuraxial anesthesia and general anesthesia for urological surgery. RESULTS The titles and abstracts of 2720 articles were analyzed. Among these, 16 studies were identified and 11 fulfilled the inclusion criteria. One RCT was published twice. The study validity was: Jadad score > 3 in one RCT; seven RCTs with unclear risk of bias as the most common response; and five RCTs not fulfilling half of the Delphi list items. The frequency of mortality was not significant between study groups in three RCTs. Meta-analysis was not performed. CONCLUSION At the moment, the evidence available cannot prove that neuraxial anesthesia is more effective and safer than general anesthesia for urological surgery. There were insufficient data to pool the results relating to mortality, stroke, myocardial infarction, length of hospitalization, quality of life, degree of satisfaction, postoperative cognitive dysfunction and blood transfusion requirements.
机译：背景与目的为降低死亡率，为泌尿外科手术选择最佳的麻醉技术仍存在争议。此处的目的是比较神经外科麻醉与全身麻醉在泌尿外科手术中的有效性和安全性。设计与设置系统评价，阿拉戈斯联邦大学。方法我们在Cochrane图书馆（2012年第10期），Medline，PubMed（1966年至2012年10月），Lilacs（1982年至2012年10月），SciELO和EMBASE（1974年至2012年10月）中搜索了Cochrane对照试验的中央登记册。还分析了所包括研究的参考文献清单以及同一领域的一篇系统综述。纳入的研究是随机对照试验（RCT），该试验分析了泌尿外科手术的神经麻醉和全身麻醉。结果分析了2720篇文章的标题和摘要。其中，确定了16项研究，其中11项符合纳入标准。一份RCT出版了两次。该研究的有效性为：一项RCT中Jadad评分> 3;七个RCTs偏倚风险不清楚，是最常见的应对措施;五个RCT不能满足Delphi列表项的一半。在三个RCT中，研究组之间的死亡率频率不显着。没有进行荟萃分析。结论目前，可用的证据还不能证明神经外科麻醉比全身麻醉更有效，更安全。没有足够的数据来收集有关死亡率，中风，心肌梗塞，住院时间，生活质量，满意度，术后认知功能障碍和输血要求的结果。

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