What do systematic reviews say?

Low‐dose opioid based general anaesthesia vs high‐dose opioid based general anaesthesia

Low‐dose opioid‐based GA showed no clear difference in mortality ‐ Death at any time after surgery compared with high‐dose opioid‐based GA (low certainty).

• Fast‐track cardiac care for adult cardiac surgical patients 2016 · Cochrane Headline outcomes only
  OR 0.53 [0.25, 1.12]
  8 studies · 1994 participants
  Low

Low‐dose opioid based general anaesthesia vs high‐dose opioid based general anaesthesia

Low‐dose opioid‐based GA showed no clear difference in postoperative myocardial infarction compared with high‐dose opioid‐based GA (low certainty).

• Fast‐track cardiac care for adult cardiac surgical patients 2016 · Cochrane Headline outcomes only
  RR 0.98 [0.48, 1.99]
  8 studies · 1683 participants
  Low

Low‐dose opioid based general anaesthesia vs high‐dose opioid based general anaesthesia

Low‐dose opioid‐based GA showed no clear difference in postoperative stroke compared with high‐dose opioid‐based GA (low certainty).

• Fast‐track cardiac care for adult cardiac surgical patients 2016 · Cochrane Headline outcomes only
  RR 1.17 [0.36, 3.78]
  5 studies · 562 participants
  Low

Low‐dose opioid based general anaesthesia vs high‐dose opioid based general anaesthesia

Low‐dose opioid‐based GA showed no clear difference in postoperative tracheal reintubation compared with high‐dose opioid‐based GA (low certainty).

• Fast‐track cardiac care for adult cardiac surgical patients 2016 · Cochrane Headline outcomes only
  RR 1.77 [0.38, 8.27]
  5 studies · 594 participants
  Low

Low‐dose opioid based general anaesthesia vs high‐dose opioid based general anaesthesia

• Fast‐track cardiac care for adult cardiac surgical patients 2016 · Cochrane Headline outcomes only
  no estimate extracted
  14 studies · 2486 participants
  Low

Low‐dose opioid based general anaesthesia vs high‐dose opioid based general anaesthesia

• Fast‐track cardiac care for adult cardiac surgical patients 2016 · Cochrane Headline outcomes only
  no estimate extracted
  12 studies · 1394 participants
  Low

Low‐dose opioid based general anaesthesia vs high‐dose opioid based general anaesthesia

• Fast‐track cardiac care for adult cardiac surgical patients 2016 · Cochrane Headline outcomes only
  no estimate extracted
  8 studies · 913 participants
  Low

Intervention not reported

It is very uncertain whether the intervention changes acute renal injury, low‐risk studies only (very low certainty).

• Interventions for protecting renal function in the perioperative period 2013 · Cochrane Headline outcomes only
  OR 1.05 [0.55, 2.03]
  16 studies · 1550 participants
  Very low

Low tidal volume vs high tidal volume

Low tidal volume showed no clear difference in mortality compared with high tidal volume (low certainty).

• Intraoperative use of low volume ventilation to decrease postoperative mortality, mechanical ventilation, lengths of… 2018 · Cochrane Headline outcomes only
  RR 0.8 [0.42, 1.53]
  12 studies · 1207 participants
  Low

Low tidal volume vs high tidal volume

Low tidal volume probably leads to lower pneumonia compared with high tidal volume (moderate certainty).

• Intraoperative use of low volume ventilation to decrease postoperative mortality, mechanical ventilation, lengths of… 2018 · Cochrane Headline outcomes only
  RR 0.45 [0.25, 0.82]
  7 studies · 778 participants
  Moderate

Low tidal volume vs high tidal volume

Low tidal volume probably leads to lower need for postoperative non‐invasive ventilatory support compared with high tidal volume (moderate certainty).

• Intraoperative use of low volume ventilation to decrease postoperative mortality, mechanical ventilation, lengths of… 2018 · Cochrane Headline outcomes only
  RR 0.31 [0.15, 0.64]
  3 studies · 506 participants
  Moderate

Low tidal volume vs high tidal volume

Low tidal volume probably leads to lower need for postoperative invasive ventilatory support compared with high tidal volume (moderate certainty).

• Intraoperative use of low volume ventilation to decrease postoperative mortality, mechanical ventilation, lengths of… 2018 · Cochrane Headline outcomes only
  RR 0.33 [0.14, 0.77]
  11 studies · 957 participants
  Moderate

Low tidal volume vs high tidal volume

• Intraoperative use of low volume ventilation to decrease postoperative mortality, mechanical ventilation, lengths of… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  5 studies · 898 participants
  Low

Low tidal volume vs high tidal volume

• Intraoperative use of low volume ventilation to decrease postoperative mortality, mechanical ventilation, lengths of… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  14 studies · 1298 participants
  Low

Low tidal volume vs high tidal volume

It is very uncertain whether low tidal volume changes barotrauma: pneumothorax compared with high tidal volume (very low certainty).

• Intraoperative use of low volume ventilation to decrease postoperative mortality, mechanical ventilation, lengths of… 2018 · Cochrane Headline outcomes only
  RR 1.77 [0.52, 5.99]
  5 studies · 708 participants
  Very low

Protocol to increase global blood flow vs control

Protocol to increase global blood flow showed no clear difference in mortality (Longest compared with control (low certainty).

• Perioperative increase in global blood flow to explicit defined goals and outcomes following surgery 2012 · Cochrane Headline outcomes only
  RR 0.89 [0.76, 1.05]
  31 studies · 5292 participants
  Low

Protocol to increase global blood flow vs control

Protocol to increase global blood flow showed no clear difference in mortality (Hospital or 28‐day) compared with control (low certainty).

• Perioperative increase in global blood flow to explicit defined goals and outcomes following surgery 2012 · Cochrane Headline outcomes only
  RR 0.81 [0.65, 1]
  31 studies · 5292 participants
  Low

Protocol to increase global blood flow vs control

Protocol to increase global blood flow may leads to lower number of patients with complications compared with control (low certainty).

• Perioperative increase in global blood flow to explicit defined goals and outcomes following surgery 2012 · Cochrane Headline outcomes only
  RR 0.68 [0.58, 0.8]
  17 studies · 1841 participants
  Low

Protocol to increase global blood flow vs control

• Perioperative increase in global blood flow to explicit defined goals and outcomes following surgery 2012 · Cochrane Headline outcomes only
  no estimate extracted
  27 studies · 4729 participants
  Low

Automated mandatory bolus vs basal infusion

• Automated mandatory bolus versus basal infusion for maintenance of epidural analgesia in labour 2023 · Cochrane Headline outcomes only
  no estimate extracted
  14 studies · 14 participants
  GRADE not reported