Effects of neuraxial and general anaesthesia for total joint arthroplasty:a meta-analysis / 临床麻醉学杂志

ABSTRACT

Objective To evaluate the effect of neuraxial and general anaesthesia for total joint arthroplasty by meta-analysis.Methods We searched online Pubmed,Web of science,Cochrane li-brary,CNKI,CBM and searched the literature of the Chinese series journals.All randomized controlled trials (RCT)that met their standards of neuraxial and general anaesthesia for total joint ar-throplasty were collected.The quality of trials was strictly assessed.RevMan 5.3 software was used for data analysis.Results Twenty-one RCTs involving 1 874 cases were included.Compared with general anaesthesia,the pooled data showed that the neuraxial anaesthesia significantly reduced blood loss (WMD=-97.52,95% CI = - 1 73.60-- 21.44,P = 0.01 ),associated with lower risk of deep vein thrombosis (RR=0.68,95%CI=0.48-0.95,P =0.02)and pulmonary embolism (RR=0.58, 95%CI=0.35-0.91,P =0.03),decreased the number of postoperative nausea and vomiting (RR=0.74,95%CI=0.60-0.92,P =0.008).Subgroup analysis showed that compared with general anaes-thesia,the neuraxial anaesthesia associated with lower risk of deep vein thrombosis (RR=0.5 1,95%CI=0.38-0.69,P < 0.000 01 )and pulmonary embolism (RR = 0.34,95% CI = 0.18-0.65,P =0.001)in patients who did not receive chemical antithrombotic prophylaxis.Conclusion Neuraxial anaesthesia seems to improve the outcome of patients undergoing total joint arthroplasty and reduce postoperative complications.