Corrigendum to: ‘Comparison of local and regional anesthesia modalities in breast surgery: A systematic review and network meta-analysis’ [Journal of Clinical Anesthesia Volume 72 (2021)/Article 110274]

BACKGROUND Patients undergoing lower limb revascularization surgery for peripheral artery disease (PAD) have a high-risk of perioperative morbidity and mortality and often have long hospital stays. Use of neuraxial or regional anesthesia instead of general anesthesia may represent one approach to improving outcomes and reducing resource use among these patients. OBJECTIVE To conduct a systematic review and meta-analysis to determine whether receipt of neuraxial or regional anesthesia instead of general anesthesia in adults undergoing lower limb revascularization surgery for PAD results in improved health outcomes and costs and a shorter length of hospitalization. METHODS We will search electronic bibliographic databases (MEDLINE, EMBASE, and the seven databases in Evidence-Based Medicine Reviews), review articles identified during the search, and included article bibliographies. We will include randomized and non-randomized studies comparing use of neuraxial or regional anesthesia instead of general anesthesia in adults undergoing lower limb revascularization surgery for PAD. Two investigators will independently evaluate risk of bias. The primary outcome will be short-term mortality (in-hospital or 30-day). Secondary outcomes will include longer-term mortality; major adverse cardiovascular, pulmonary, and renal events; delirium; deep vein thrombosis or pulmonary embolism; major adverse limb events; neuraxial or regional anesthesia-related complications; graft-related outcomes; length of operation and hospital stay; costs; and patient-reported or functional outcomes. We will calculate summary odds ratios and standardized mean differences using random-effects models. Heterogeneity will be explored using stratified meta-analyses and meta-regression. We will assess for publication bias using Begg’s and Egger’s tests and use the trim-and-fill method to estimate the potential influence of this bias on summary estimates. Finally, we will use Grading of Recommendations, Assessment, Development, and Evaluation methodology to make an overall rating of the quality of evidence in our effect estimates. RESULTS The protocol was registered in PROSPERO, the international register of systematic reviews. CONCLUSIONS This study will synthesize existing evidence regarding whether receipt of neuraxial or regional anesthesia instead of general anesthesia in adults undergoing lower limb revascularization surgery for PAD results in improved health outcomes, graft patency, and costs, and a shorter length of hospital stay. Study results will be used to inform practice and future research, including creation of a pilot and then multicenter randomized controlled trial. CLINICALTRIAL PROSPERO CRD42021237060.

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Perineural versus intravenous dexamethasone as an adjuvant in regional anesthesia: a systematic review and meta-analysis

Journal of Pain Research ◽

10.2147/jpr.s138212 ◽

2017 ◽

Vol Volume 10 ◽

pp. 1529-1543 ◽

Cited By ~ 5

Author(s):

Wenling Zhao ◽

Xiaofeng Ou ◽

Jin Liu ◽

Wensheng Zhang

Keyword(s):

Systematic Review ◽

Regional Anesthesia ◽

Meta Analysis

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Impact of parallel processing of regional anesthesia with block rooms on resource utilization and clinical outcomes: a systematic review and meta-analysis

Regional Anesthesia and Pain Medicine ◽

10.1136/rapm-2020-101397 ◽

2020 ◽

Vol 45 (9) ◽

pp. 720-726

Author(s):

Kariem El-Boghdadly ◽

Ganeshkrishna Nair ◽

Amit Pawa ◽

Desire N. Onwochei

Keyword(s):

Systematic Review ◽

Parallel Processing ◽

Clinical Outcomes ◽

Regional Anesthesia ◽

Resource Utilization ◽

Meta Analysis ◽

Research Centre ◽

Postanesthesia Care Unit ◽

Serial Processing ◽

Pacu Stay

Block rooms allow parallel processing of surgical patients with the purported benefits of improving resource utilization and patient outcomes. There is disparity in the literature supporting these suppositions. We aimed to synthesize the evidence base for parallel processing by conducting a systematic review and meta-analysis. A systematic search was undertaken of Medline, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the National Health Service (NHS) National Institute for Health Research Centre for Reviews and Dissemination database, and Google Scholar for terms relating to regional anesthesia and block rooms. The primary outcome was anesthesia-controlled time (ACT; time from entry of the patient into the operating room (OR) until the start of surgical prep plus surgical closure to exit of patient from the OR). Secondary outcomes of interest included other resource-utilization parameters such as turnover time (TOT; time between the exit of one patient from the OR and the entry of another), time spent in the postanesthesia care unit (PACU), OR throughput, and clinical outcomes such as pain scores, nausea and vomiting, and patient satisfaction. Fifteen studies were included involving 8888 patients, of which 3364 received care using a parallel processing model. Parallel processing reduced ACT by a mean difference (95% CI) of 10.4 min (16.3 to 4.5; p<0.0001), TOT by 16.1 min (27.4 to 4.8; p<0.0001) and PACU stay by 26.6 min (47.1 to 6.1; p=0.01) when compared with serial processing. Moreover, parallel processing increased daily OR throughout by 1.7 cases per day (p<0.0001). Clinical outcomes all favored parallel processing models. All studies showed moderate-to-critical levels of bias. Parallel processing in regional anesthesia appears to reduce the ACT, TOT, PACU time and improved OR throughput when compared with serial processing. PROSPERO CRD42018085184.

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The efficacy and safety of percutaneous nephrolithotomy under general versus regional anesthesia: a systematic review and meta-analysis

Urolithiasis ◽

10.1007/s00240-015-0776-2 ◽

2015 ◽

Vol 43 (5) ◽

pp. 455-466 ◽

Cited By ~ 13

Author(s):

Chunxiao Pu ◽

Jia Wang ◽

Yin Tang ◽

Haichao Yuan ◽

Jinhong Li ◽

...

Keyword(s):

Systematic Review ◽

Regional Anesthesia ◽

Percutaneous Nephrolithotomy ◽

Meta Analysis ◽

Efficacy And Safety

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The Role of Dexmedetomidine as an Additive to Intravenous Regional Anesthesia: A Systematic Review and Meta-analysis

Balkan Medical Journal ◽

10.5152/balkanmedj.2021.20076 ◽

2021 ◽

Author(s):

Iosifina Karmaniolou ◽

◽

Chryssoula Staikou ◽

Pavol Surda ◽

◽

...

Keyword(s):

Systematic Review ◽

Regional Anesthesia ◽

Meta Analysis ◽

Intravenous Regional Anesthesia

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Outcomes After Receipt of Neuraxial or Regional Anesthesia Instead of General Anesthesia for Lower Limb Revascularization Surgery: Protocol for a Systematic Review and Meta-Analysis

10.21203/rs.3.rs-249672/v1 ◽

2021 ◽

Author(s):

Derek J. Roberts ◽

Hannah Dreksler ◽

Sudhir K. Nagpal ◽

Allen Li ◽

Jeanna Parsons Leigh ◽

...

Keyword(s):

Systematic Review ◽

Health Outcomes ◽

Hospital Stay ◽

General Anesthesia ◽

Regional Anesthesia ◽

Lower Limb ◽

Meta Analysis ◽

Study Results ◽

Multicenter Randomized Controlled Trial ◽

Revascularization Surgery

Abstract Background: Patients undergoing lower limb revascularization surgery have a high-risk of perioperative morbidity and mortality and often have long hospital stays. Use of neuraxial or regional anesthesia instead of general anesthesia may represent one approach to improving outcomes and reducing resource use among these patients. We propose to conduct a systematic review and meta-analysis to determine whether receipt of neuraxial or regional anesthesia instead of general anesthesia in adults undergoing lower limb revascularization surgery results in improved health outcomes and costs and a shorter length of hospitalization. Methods: We will search electronic bibliographic databases (MEDLINE, EMBASE, and the seven databases in Evidence-Based Medicine Reviews), review articles identified during the search, and included article bibliographies. We will include randomized and non-randomized studies comparing use of neuraxial or regional anesthesia instead of general anesthesia in adults undergoing lower limb revascularization surgery. Two investigators will independently evaluate risk of bias. The primary outcome will be short-term mortality (in-hospital or 30-day). Secondary outcomes will include longer-term mortality; major adverse cardiovascular, pulmonary, and renal events; delirium; deep vein thrombosis or pulmonary embolism; major adverse limb events; neuraxial or regional anesthesia-related complications; graft-related outcomes; length of operation and hospital stay; costs; and patient-reported or functional outcomes. We will calculate summary odds ratios and standardized mean differences using random-effects models. Heterogeneity will be explored using stratified meta-analyses and meta-regression. We will assess for publication bias using Begg’s and Egger’s tests and use the trim-and-fill method to estimate the potential influence of this bias on summary estimates. Finally, we will use Grading of Recommendations, Assessment, Development, and Evaluation methodology to make an overall rating of the quality of evidence in our effect estimates.Discussion: This study will synthesize existing evidence regarding whether receipt of neuraxial or regional anesthesia instead of general anesthesia in adults undergoing lower limb revascularization surgery results in improved health outcomes, graft patency, and costs, and a shorter length of hospital stay. Study results will be used to inform practice and future research, including creation of a pilot and then multicenter randomized controlled trial. Systematic Review Registration: Submitted to PROSPERO February 12, 2020.

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