Effect of intrathecal blockade on postoperative myocardial infarction in noncardiac surgical patients: a meta-analysis / 临床麻醉学杂志

ABSTRACT

Objective A meta-analysis was conducted to figure out the effects of anesthetic methods on postoperative myocardial infarction in noncardiac surgery patients.Methods We searched PubMed, Embase, Ovid, Cochrane Library, Google scholar, CNKI, Wang-fang data and VIP Database (by September 2016) to identify relevant studies that focused on the effect of intrathecal blockade on postoperative myocardial infarction and mortality in non-cardiac surgery.Meta-analysis was performed using software of RevMan 5.3.Results A total of 21 859 patients from 10 RCTs were enrolled.The meta-analysis showed that there were no differences in myocardial infarction within 7 postoperative days (OR=0.44, 95%CI 0.13-1.46, P=0.18) or 30 days (OR=1.49, 95%CI 0.89-2.49, P=0.13) and all-cause mortality (OR=1.26, 95%CI 0.84-1.88, P=0.26) between epidural anesthesia combined with general anesthesia and general anesthesia.Furthermore, there were no differences in myocardial infarction within postoperative 7 days (OR=1.14, 95%CI 0.31-4.17, P=0.84) and all-cause mortality within postoperative 30 days (OR=0.88, 95%CI 0.43-1.79, P=0.73) between spinal anesthesia alone and general anesthesia alone.Conclusion Intrathecal blockade cannot affect the incidence of myocardial infarction and mortality in high-risk cardiac patients undergoing intermediate or high-risk non-cardiac surgery.