Peripheral nerve block and cognitive impairment after thoracic surgery: a systematic review and meta-analysis.
Minerva Anestesiol
; 90(5): 417-426, 2024 05.
Article
em En
| MEDLINE
| ID: mdl-38289296
ABSTRACT
INTRODUCTION:
Postoperative cognitive impairment is common in surgical patients, including postoperative delirium and postoperative cognitive dysfunction. Several studies investigating the association between peripheral nerve block and the risk of cognitive impairment after thoracic surgery showed conflicting results. Therefore, we conducted the current systematic review and meta-analysis to determine the effects of peripheral nerve block on postoperative cognitive impairment in thoracic surgical patients. EVIDENCE ACQUISITION Eligible randomized controlled trials were retrieved from PubMed, Cochrane Library, Web of Science and Embase databases. The primary outcomes were the incidence of postoperative delirium or cognitive dysfunction and the MMSE scores. Furthermore, VAS scores, levels of TNF-α and IL-6, as well as the duration of hospitalization were analyzed as secondary outcomes. EVIDENCESYNTHESIS:
Ten articles including 1279 participants were selected for this meta-analysis. The results showed that peripheral nerve block could lessen the incidence of postoperative delirium or cognitive dysfunction (OR=0.39, 95% CI [0.27 to 0.56]), the scores of VAS (MD=-1.35 [95% CI -2.30 to -0.40]), the values of TNF-α (SMD=-1.13 [95% CI -1.49 to -0.76]) and IL-6 (SMD=-1.65 [95% CI -1.87 to -1.42]), as well as the length of hospitalization (MD=-0.70 [95% CI -0.96 to -0.43]). In addition, peripheral nerve block was linked to a significant increase in MMSE scores (MD=2.16 [95% CI 1.40 to 2.91]).CONCLUSIONS:
This meta-analysis revealed positive effects of peripheral nerve block on improving postoperative cognitive impairment in patients following thoracic surgery.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Procedimentos Cirúrgicos Torácicos
/
Bloqueio Nervoso
Tipo de estudo:
Clinical_trials
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Minerva Anestesiol
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
China