General Anaesthesia Does Not Contribute to Long-term Post-operative Cognitive Dysfunction in Adults: A Meta-analysis

Overview

Journal Indian J Anaesth

Specialty Anesthesiology

Date 2011 Oct 21

PMID 22013251

Citations 20

Authors

Joanne Guay

Affiliations

Soon will be listed here.

Abstract

Context: The contribution of anaesthesia itself to post-operative cognitive dysfunction (POCD) or the potential protective effect of one specific type of anaesthesia on the occurrence of POCD is unclear.

Aims: This is a meta-analysis evaluating the effects of the anaesthetic technique (regional vs. general anaesthesia) on POCD of patients undergoing non-cardiac surgery.

Settings And Design: Meta-analysis performed in a University affiliated hospital.

Methods: A search for randomized controlled trials (RCT) comparing regional anaesthesia to general anaesthesia for surgery was done in PUBMED, MEDLINE, EMBASE, EBM Reviews-Cochrane Central Register of Controlled Trials, PsychINFO and Current Contents/all editions in 2009.

Statistical Analysis: Data were analyzed with comprehensive Meta-analysis Version 2.2.044.

Results: Twenty-six RCTs including 2365 patients: 1169 for regional anaesthesia and 1196 for general anaesthesia were retained. The standardized difference in means for the tests included in the 26 RCTs was -0.08 (95% confidence interval: -0.17-0.01; P value 0.094; I-squared = 0.00%). The assessor was blinded to the anaesthetic technique for 12 of the RCTs including only 798 patients: 393 for regional anaesthesia and 405 for general anaesthesia. The standardized difference in means for these 12 studies is 0.05 (-0.10-0.20; P=0.51; I-squared = 0.00%).

Conclusions: The present meta-analysis does not support the concerns that a single exposure to general anaesthesia in an adult would significantly contribute to permanent POCD after non-cardiac surgery.

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