A eficiência da anestesia neuroaxial comparada à anestesia geral para a revascularização dos membros inferiores em idosos: revisão sistemática com metanálise de ensaios clínicos aleatórios

Context. One of the most controversial subjects in anaesthesia today is whether or not neuraxial anaesthesia is more efficient to general anaesthesia in high-risk patients undergoing noncardiac surgery. The cumulative results showed that the incidence of postoperative cardiovascular morbidity and mo...

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Detalles Bibliográficos
Autor: Barbosa, Fabiano Timbó
Tipo de recurso: tesis de maestría
Estado:Versión publicada
Fecha de publicación:2008
País:Brasil
Institución:Universidade Federal de Alagoas (UFAL)
Repositorio:Repositório Institucional da Universidade Federal de Alagoas (UFAL)
Idioma:portugués
OAI Identifier:oai:www.repositorio.ufal.br:riufal/907
Acceso en línea:http://repositorio.ufal.br/handle/riufal/907
Access Level:acceso embargado
Palabra clave:Efficiency
Anesthesia, general
Anesthesia, conduction
Reperfusion
Limb salvage
Elderly
Mortality
Cerebral infarction
Myocardial infarction
Postoperative period
Randomized controlled trials
Meta-analyse
Eficiência
Anestesia geral
Anestesia regional
Reperfusão
Salvamento de membro
Idoso
Mortalidade
Infarto cerebral
Infarto cardíaco
Período pós-operatório
Ensaios clínicos aleatórios
Metanálise
CNPQ::CIENCIAS DA SAUDE::MEDICINA::CIRURGIA::ANESTESIOLOGIA
Descripción
Sumario:Context. One of the most controversial subjects in anaesthesia today is whether or not neuraxial anaesthesia is more efficient to general anaesthesia in high-risk patients undergoing noncardiac surgery. The cumulative results showed that the incidence of postoperative cardiovascular morbidity and mortality is similar, regardless of type of the anaesthesia. So, is relevant to answer the search question: what is the efficiency of the neuraxial anaesthesia compared with general anaesthesia for lower-limbs revascularization in elderly? Objective. It is to determine the efficiency of the neuraxial anaestheisa versus general anaesthesia for lower-limbs revascularization in elderly. Hypothesis. The hypothesis is that the neuraxial anaestesia is more efficient (OR 0.67) than general anaesthesia for lower-limbs revascularization in elderly. Design. Systematic review with meta-analyse of the original articles of the randomized controlled trials. Setting. Federal University of Alagoas, Maceió, AL. Sample. Original articles of the randomized controlled trials that compared two anaesthetic technique (neuraxial anaesthesia vs. general anaesthesia) in elderly submitted to lower-limbs revascularization surgery. The information was accessed from EMBASE, LILACS, MEDLINE, CINHAL and ISI WEB OF SCIENCE. Main outcomes. Primary outcomes: Mortality, cerebral infarction, myocardial infarction, paralysis and postoperative lower limb amputation rate. Secondary outcomes: Duration of hospital stay, postoperative cognitive dysfunction, postoperative wound infection, other postoperative infections, neuraxial haematoma and complications in the anaesthetic recovery room. Complementary data: internal validity, external validity and statistical analyze. Statistical methods. For data analysis the odds ratio were used in the randon effect model with corresponding 95% confidence interval.