Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942012000200009
Brazilian Journal of Anesthesiology
Miscellaneous

Anestesia neuroaxial comparada à anestesia geral para procedimentos na metade inferior do corpo: revisão sistemática de revisões sistemáticas

Neuraxial anesthesia compared to general anesthesia for procedures on the lower half of the body: systematic review of systematic reviews

Fabiano Timbó Barbosa; Aldemar Araújo Castro; Cláudio Torres de Miranda

http://dx.doi.org/10.1590/S0034-70942012000200009 Braz J Anesthesiol, vol.62, n2, p.239-243, 2012
PDF Português
PDF English
Downloads: 0
Views: 943

Resumo

JUSTIFICATIVA E OBJETIVOS: As revisões sistemáticas organizam dados da literatura, combinando os resultados dos estudos publicados com o objetivo de resolver conflitos na área do conhecimento médico descrevendo as intervenções. O relato inadequado das revisões sistemáticas pode prejudicar sua credibilidade e interferir na qualidade de seus resultados. O objetivo deste estudo foi determinar a frequência de revisões sistemáticas de boa qualidade que comparam a anestesia neuroaxial com a anestesia geral para procedimentos na metade inferior do corpo. MÉTODO: Revisão sistemática de revisões sistemáticas, com variável primária sendo a frequência de revisões sistemáticas de boa qualidade. As informações foram analisadas a partir dos seguintes bancos de dados: LILACS (janeiro de 1982 a dezembro de 2010), PubMed (janeiro de 1950 a dezembro de 2010), Cochrane Database of Systematic Review e Database of Abstracts of Reviews of Effects (volume 10, 2010), e SciELO (em dezembro de 2010). A qualidade das revisões sistemáticas foi determinada pelo Overview Quality Assessment Questionnaire. O cálculo do tamanho da amostra demonstrou ser necessária a análise de 8 revisões sistemáticas, considerando que a frequência de revisões sistemáticas de boa qualidade foi de 5%, a precisão absoluta de 15% e o nível de significância de 5%. RESULTADOS: Foram identificados 1.995 artigos. O processo de seleção eliminou 1.968 artigos. Foram lidos 27 artigos de revisões sistemáticas na íntegra, foram excluídos 9 devido à incompatibilidade com os critérios de inclusão, e 8 eram publicações duplicadas. Dez revisões sistemáticas foram analisadas quanto a sua qualidade. A frequência de revisões sistemáticas de boa qualidade foi de 40% (4/10; IC 95% 9,6 a 70,4%). CONCLUSÃO: A frequência de revisões sistemáticas de boa qualidade foi de 40%.

Palavras-chave

ANESTESIA, ANESTESIOLOGIA, ANESTESIOLOGIA

Abstract

BACKGROUND AND OBJECTIVES: Systematic reviews organize literature data by combining results from published studies in order to resolve conflicts in the area of medical knowledge describing the interventions. The inadequate reporting of systematic reviews can damage the credibility and interfere in the results' quality. The objective of this study was to determine the frequency of good quality systematic reviews comparing neuraxial anesthesia with general anesthesia for procedures on the lower half of the body. METHODS: Systematic review of systematic reviews. Primary variable: The frequency of good quality systematic reviews. The information was analyzed from the following databases: LILACS (January 1982 to December 2010); PubMed (January 1950 to December 2010); The Cochrane Database of Systematic Review and Database of Abstracts of Reviews of Effects (volume 10, 2010); and SciELO (December 2010). The quality of systematic reviews was determined by the Overview Quality Assessment Questionnaire. The sample size calculation showed that it was necessary to analyze eight systematic reviews, taking into account that the frequency of good quality systematic reviews was 5%, an absolute precision of 15%, and a significance level of 5%. RESULTS: Were identified 1,995 articles. The selection process eliminated 1,968 articles. Twenty-seven articles of systematic reviews were read in full, 9 were excluded due to incompatibility with the inclusion criteria, and 8 were duplicate publications. Ten systematic reviews were assessed for their quality. The frequency of good quality systematic reviews was 40% (4/10; 95% CI 9.6 to 70.4%). CONCLUSION: The frequency of good quality systematic reviews was 40%.

Keywords

Anesthesia, Anesthesia, Anesthesia, Meta-Analysis, Publications

Referencias

Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2. Marc.

Flather MD, Farkouh ME, Pogue JM, Yusuf S. Strengths and limitations of meta-analysis: larger studies may be more reliable. Control Clin Trials. 1997;18:568-579.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151:264-269.

Oxman AD, Guyatt GH. Validation of an index of the quality of review articles. J Clin Epidemiol. 1991;44:1271-1278.

Oxman AD, Guyatt GH, Singer J. Agreement among reviewers of review articles. J Clin Epidemiol. 1991;44:91-98.

Kelly KD, Travers A, Dorgan M, Slater L, Rowe BH. Evaluating the quality of systematic reviews in the emergency medicine literature. Ann Emerg Med. 2001;38:518-526.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(6).

Barbosa FT, Cavalcante JC, Jucá MJ, Castro AA. Neuraxial anaesthesia for lower-limb revascularization. Cochrane Database Syst Rev. 2010.

Macfarlane AJ, Prasad GA, Chan VW, Brull R. Does regional anaesthesia improve outcome after total hip arthroplasty?: A systematic review. Br J Anaesth. 2009;103:335-345.

Hu S, Zhang ZY, Hua YQ, Li J, Cai ZD. A comparison of regional and general anaesthesia for total replacement of the hip or knee: a metaanalysis. J Bone Joint Surg Br. 2009;91:935-942.

Mauermann WJ, Shilling AM, Zuo Z. A comparison of neuraxial block versus general anesthesia for elective total hip replacement: a metaanalysis. Anesth Analg. 2006;103:1018-1025.

Guay J. The effect of neuraxial blocks on surgical blood loss and blood transfusion requirements: a meta-analysis. J Clin Anesth. 2006;18:124-128.

Parker MJ, Handoll HHG, Griffiths R. Anaesthesia for hip fracture surgery in adults. Cochrane Database Syst Rev. 2001.

Urwin SC, Parker MJ, Griffiths R. General versus regional anaesthesia for hip fracture surgery: a met -analysis of randomized trials. Br J Anaesth. 2000;84:450-455.

Afolabi BB, Lesi AFE, Merah NA. Regional versus general anaesthesia for caesarean section. Cochrane Database Syst Rev. 2006.

Craven PD, Badawi N, Henderson-Smart DJ, OBrien M. Regional (spinal, epidural, caudal) versus general anaesthesia in preterm infants undergoing inguinal herniorrhaphy in early infancy. Cochrane Database Syst Rev. 2003.

Liu SS, Strodtbeck WM, Richman JM, Wu CL. A comparison of regional versus general anesthesia for ambulatory anesthesia: a meta-analysis of randomized controlled trials. Anesth Analg. 2005;101:1634-1642.

Wilson A, Henry DA. Principles behind practice: meta-analysis. Part 2: assessing the quality of published meta-analyses. Med J Aust. 1992;156:173-187.

Moher D, Pham B, Jones A. Does quality of reports of randomized trials affect estimates of intervention efficacy reported in metaanalyses?. Lancet. 1998;22(352):609-613.

5dd54b590e8825366dc8fca7 rba Articles
Links & Downloads
2352-2291 (Electrónico) 0104-0014 (Impreso)
Braz J Anesthesiol ©2024 Todos los derechos reservados.

Braz J Anesthesiol

Share this page
Page Sections