Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

87 questions · 95 findings · 18 reviews · Anaesthesia

No studies found 5 · 5.3%GRADE not reported 2 · 2.1%Very low 28 · 29.5%Low 39 · 41.1%Moderate 21 · 22.1%High 0 · 0%

Perioperative restrictive fluid therapy vs goal‐directed fluid therapy

Renal failure · adults receiving intravenous fluids while undergoing major non‐cardiac surgery

It is very uncertain whether perioperative restrictive fluid therapy changes renal failure (during longest compared with goal‐directed fluid therapy (very low certainty).

1 finding from 1 review

Perineural vs intravenous dexamethasone

Incidence of serious adverse events (we used the NIH definition of adverse events. A serious event includes death, a life‐threatening event that requires hospitalization or prolonged hospitalization, disability or congenital anomaly) · peripheral nerve block

The review found no eligible studies for this question.

1 finding from 1 review

Perineural vs intravenous dexamethasone

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · peripheral nerve block
3 findings from 1 review

Supplemental IV crystalloid vs control IV crystalloid volume

Nausea · participants aged 6 months or older undergoing surgical procedures under general anaesthesia

Supplemental IV crystalloid probably leads to lower risk of PON, defined as the presence of subjective nausea, reported… compared with control IV crystalloid volume (moderate certainty).

1 finding from 1 review

Supplemental IV crystalloid vs control IV crystalloid volume

Risk of POV, reported dichotomously by any discrete episodes of vomiting · participants aged 6 months or older undergoing surgical procedures under general anaesthesia

Supplemental IV crystalloid probably leads to lower risk of POV, reported dichotomously by any discrete episodes of… compared with control IV crystalloid volume (moderate certainty).

1 finding from 1 review

Supplemental IV crystalloid vs control IV crystalloid volume

Risk of requiring pharmacologic treatment for PONV, reported dichotomously as the use of any medication intended to treat nausea or vomiting during the postoperative period · participants aged 6 months or older undergoing surgical procedures under general anaesthesia

Supplemental IV crystalloid probably leads to lower risk of requiring pharmacologic treatment for PONV, reported… compared with control IV crystalloid volume (moderate certainty).

1 finding from 1 review

Supplemental IV crystalloid vs control IV crystalloid volume

Risk of unintended postoperative admission to hospital, reported dichotomously as admission to an inpatient unit of a participant after an intended ambulatory surgical procedure · participants aged 6 months or older undergoing surgical procedures under general anaesthesia

Supplemental IV crystalloid showed no clear difference in risk of unintended postoperative admission to hospital, reported… compared with control IV crystalloid volume (low certainty).

1 finding from 1 review

Supplemental IV crystalloid vs control IV crystalloid volume

Risk of suffering a serious adverse event, reported dichotomously as the occurrence of any of: admission to high‐dependency unit, postoperative cardiac or respiratory complication, or death · participants aged 6 months or older undergoing surgical procedures under general anaesthesia

The review found no eligible studies for this question.

1 finding from 1 review

Summary of findings TIVA vs inhalational maintenance of anaesthesia

Postoperative delirium (One study used DRS, three studies used CAM and in one study diagnostic tool was not reported) Time points were up to 4 days postoperatively

It is very uncertain whether summary of findings TIVA changes postoperative delirium (One study used DRS, three studies used CAM… compared with inhalational maintenance of anaesthesia (very low certainty).

1 finding from 1 review

Summary of findings TIVA vs inhalational maintenance of anaesthesia

Postoperative cognitive dysfunction (9 studies used MMSE, and 2 of these studies used additional diagnostic tools; 1 study used Trail Making Test and additional diagnostic tools; 3 studies did not report diagnostic tools) Time points were up to 30...

Summary of findings TIVA may leads to lower postoperative cognitive dysfunction (9 studies used MMSE, and 2 of… compared with inhalational maintenance of anaesthesia (low certainty).

1 finding from 1 review