Impact of epidural analgesia on mortality and morbidity after surgery: systematic review and meta-analysis of randomized controlled trials.
Identifieur interne : 003648 ( PubMed/Curation ); précédent : 003647; suivant : 003649Impact of epidural analgesia on mortality and morbidity after surgery: systematic review and meta-analysis of randomized controlled trials.
Auteurs : Daniel M. Pöpping [Suisse] ; Nadia Elia ; Hugo K. Van Aken ; Emmanuel Marret ; Stephan A. Schug ; Peter Kranke ; Manuel Wenk ; Martin R. TramèrSource :
- Annals of surgery [ 1528-1140 ] ; 2014.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- epidemiology : Postoperative Complications.
- methods : Analgesia, Epidural.
- prevention & control : Postoperative Complications.
- trends : Morbidity, Survival Rate.
- Adult, Global Health, Humans, Prognosis, Randomized Controlled Trials as Topic, Surgical Procedures, Operative.
Abstract
To quantify benefit and harm of epidural analgesia, compared with systemic opioid analgesia, in adults having surgery under general anesthesia.
DOI: 10.1097/SLA.0000000000000237
PubMed: 24096762
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Pöpping</name><affiliation wicri:level="1"><nlm:affiliation>*Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Germany †Faculty of Medicine, Institute of Social and Preventive Medicine, University of Geneva, Switzerland ‡Department of Anesthesia and Intensive Care, Tenon University Hospital, Assistance Publique Hôpitaux de Paris, France §Anesthesiology Unit, School of Medicine and Pharmacology, University of Western Australia, Australia ¶Department of Anesthesia and Critical Care, University Hospital of Würzburg, Germany ‖Division of Anesthesiology, Geneva University Hospitals, and Faculty of Medicine, University of Geneva, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>*Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Germany †Faculty of Medicine, Institute of Social and Preventive Medicine, University of Geneva, Switzerland ‡Department of Anesthesia and Intensive Care, Tenon University Hospital, Assistance Publique Hôpitaux de Paris, France §Anesthesiology Unit, School of Medicine and Pharmacology, University of Western Australia, Australia ¶Department of Anesthesia and Critical Care, University Hospital of Würzburg, Germany ‖Division of Anesthesiology, Geneva University Hospitals, and Faculty of Medicine, University of Geneva</wicri:regionArea></affiliation></author><author><name sortKey="Elia, Nadia" sort="Elia, Nadia" uniqKey="Elia N" first="Nadia" last="Elia">Nadia Elia</name></author><author><name sortKey="Van Aken, Hugo K" sort="Van Aken, Hugo K" uniqKey="Van Aken H" first="Hugo K" last="Van Aken">Hugo K. Van Aken</name></author><author><name sortKey="Marret, Emmanuel" sort="Marret, Emmanuel" uniqKey="Marret E" first="Emmanuel" last="Marret">Emmanuel Marret</name></author><author><name sortKey="Schug, Stephan A" sort="Schug, Stephan A" uniqKey="Schug S" first="Stephan A" last="Schug">Stephan A. Schug</name></author><author><name sortKey="Kranke, Peter" sort="Kranke, Peter" uniqKey="Kranke P" first="Peter" last="Kranke">Peter Kranke</name></author><author><name sortKey="Wenk, Manuel" sort="Wenk, Manuel" uniqKey="Wenk M" first="Manuel" last="Wenk">Manuel Wenk</name></author><author><name sortKey="Tramer, Martin R" sort="Tramer, Martin R" uniqKey="Tramer M" first="Martin R" last="Tramèr">Martin R. 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Van Aken</name></author><author><name sortKey="Marret, Emmanuel" sort="Marret, Emmanuel" uniqKey="Marret E" first="Emmanuel" last="Marret">Emmanuel Marret</name></author><author><name sortKey="Schug, Stephan A" sort="Schug, Stephan A" uniqKey="Schug S" first="Stephan A" last="Schug">Stephan A. Schug</name></author><author><name sortKey="Kranke, Peter" sort="Kranke, Peter" uniqKey="Kranke P" first="Peter" last="Kranke">Peter Kranke</name></author><author><name sortKey="Wenk, Manuel" sort="Wenk, Manuel" uniqKey="Wenk M" first="Manuel" last="Wenk">Manuel Wenk</name></author><author><name sortKey="Tramer, Martin R" sort="Tramer, Martin R" uniqKey="Tramer M" first="Martin R" last="Tramèr">Martin R. Tramèr</name></author></analytic><series><title level="j">Annals of surgery</title><idno type="eISSN">1528-1140</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Analgesia, Epidural (methods)</term><term>Global Health</term><term>Humans</term><term>Morbidity (trends)</term><term>Postoperative Complications (epidemiology)</term><term>Postoperative Complications (prevention & control)</term><term>Prognosis</term><term>Randomized Controlled Trials as Topic</term><term>Surgical Procedures, Operative</term><term>Survival Rate (trends)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Analgésie péridurale ()</term><term>Complications postopératoires ()</term><term>Complications postopératoires (épidémiologie)</term><term>Essais contrôlés randomisés comme sujet</term><term>Humains</term><term>Morbidité (tendances)</term><term>Procédures de chirurgie opératoire</term><term>Pronostic</term><term>Santé mondiale</term><term>Taux de survie (tendances)</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Analgesia, Epidural</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="tendances" xml:lang="fr"><term>Morbidité</term><term>Taux de survie</term></keywords><keywords scheme="MESH" qualifier="trends" xml:lang="en"><term>Morbidity</term><term>Survival Rate</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Complications postopératoires</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Global Health</term><term>Humans</term><term>Prognosis</term><term>Randomized Controlled Trials as Topic</term><term>Surgical Procedures, Operative</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Analgésie péridurale</term><term>Complications postopératoires</term><term>Essais contrôlés randomisés comme sujet</term><term>Humains</term><term>Procédures de chirurgie opératoire</term><term>Pronostic</term><term>Santé mondiale</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">To quantify benefit and harm of epidural analgesia, compared with systemic opioid analgesia, in adults having surgery under general anesthesia.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">24096762</PMID><DateCreated><Year>2014</Year><Month>05</Month><Day>12</Day></DateCreated><DateCompleted><Year>2014</Year><Month>06</Month><Day>27</Day></DateCompleted><DateRevised><Year>2014</Year><Month>11</Month><Day>20</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1528-1140</ISSN><JournalIssue CitedMedium="Internet"><Volume>259</Volume><Issue>6</Issue><PubDate><Year>2014</Year><Month>Jun</Month></PubDate></JournalIssue><Title>Annals of surgery</Title><ISOAbbreviation>Ann. Surg.</ISOAbbreviation></Journal><ArticleTitle>Impact of epidural analgesia on mortality and morbidity after surgery: systematic review and meta-analysis of randomized controlled trials.</ArticleTitle><Pagination><MedlinePgn>1056-67</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1097/SLA.0000000000000237</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To quantify benefit and harm of epidural analgesia, compared with systemic opioid analgesia, in adults having surgery under general anesthesia.</AbstractText><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">It remains controversial whether adding epidural analgesia to general anesthesia decreases postoperative morbidity and mortality.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We searched CENTRAL, EMBASE, PubMed, CINAHL, and BIOSIS till July 2012. We included randomized controlled trials comparing epidural analgesia (with local anesthetics, lasting for ≥ 24 hours postoperatively) with systemic analgesia in adults having surgery under general anesthesia, and reporting on mortality or any morbidity endpoint.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">A total of 125 trials (9044 patients, 4525 received epidural analgesia) were eligible. In 10 trials (2201 patients; 87 deaths), reporting on mortality as a primary or secondary endpoint, the risk of death was decreased with epidural analgesia (3.1% vs 4.9%; odds ratio, 0.60; 95% confidence interval, 0.39-0.93). Epidural analgesia significantly decreased the risk of atrial fibrillation, supraventricular tachycardia, deep vein thrombosis, respiratory depression, atelectasis, pneumonia, ileus, and postoperative nausea and vomiting, and also improved recovery of bowel function, but significantly increased the risk of arterial hypotension, pruritus, urinary retention, and motor blockade. Technical failures occurred in 6.1% of patients.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">In adults having surgery under general anesthesia, concomitant epidural analgesia reduces postoperative mortality and improves a multitude of cardiovascular, respiratory, and gastrointestinal morbidity endpoints compared with patients receiving systemic analgesia. Because adverse effects and technical failures cannot be ruled out, individual risk-benefit analyses and professional care are recommended.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Pöpping</LastName><ForeName>Daniel M</ForeName><Initials>DM</Initials><AffiliationInfo><Affiliation>*Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Germany †Faculty of Medicine, Institute of Social and Preventive Medicine, University of Geneva, Switzerland ‡Department of Anesthesia and Intensive Care, Tenon University Hospital, Assistance Publique Hôpitaux de Paris, France §Anesthesiology Unit, School of Medicine and Pharmacology, University of Western Australia, Australia ¶Department of Anesthesia and Critical Care, University Hospital of Würzburg, Germany ‖Division of Anesthesiology, Geneva University Hospitals, and Faculty of Medicine, University of Geneva, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Elia</LastName><ForeName>Nadia</ForeName><Initials>N</Initials></Author><Author ValidYN="Y"><LastName>Van Aken</LastName><ForeName>Hugo K</ForeName><Initials>HK</Initials></Author><Author ValidYN="Y"><LastName>Marret</LastName><ForeName>Emmanuel</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Schug</LastName><ForeName>Stephan A</ForeName><Initials>SA</Initials></Author><Author ValidYN="Y"><LastName>Kranke</LastName><ForeName>Peter</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Wenk</LastName><ForeName>Manuel</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Tramèr</LastName><ForeName>Martin R</ForeName><Initials>MR</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D017418">Meta-Analysis</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Ann Surg</MedlineTA><NlmUniqueID>0372354</NlmUniqueID><ISSNLinking>0003-4932</ISSNLinking></MedlineJournalInfo><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Ann Surg. 2014 Jun;259(6):1070-2</RefSource><PMID Version="1">24814504</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Ann Surg. 2014 Jun;259(6):1068-9</RefSource><PMID Version="1">24814503</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015360" MajorTopicYN="N">Analgesia, Epidural</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014943" MajorTopicYN="N">Global Health</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009017" MajorTopicYN="N">Morbidity</DescriptorName><QualifierName UI="Q000639" MajorTopicYN="N">trends</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011183" MajorTopicYN="N">Postoperative Complications</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011379" MajorTopicYN="N">Prognosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016032" MajorTopicYN="Y">Randomized Controlled Trials as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013514" MajorTopicYN="N">Surgical Procedures, Operative</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015996" MajorTopicYN="N">Survival Rate</DescriptorName><QualifierName UI="Q000639" MajorTopicYN="N">trends</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2013</Year><Month>10</Month><Day>8</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2013</Year><Month>10</Month><Day>8</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2014</Year><Month>6</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">24096762</ArticleId><ArticleId IdType="doi">10.1097/SLA.0000000000000237</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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