Cochrane · systematic review · CD006715
Epidural analgesia for adults undergoing cardiac surgery with or without cardiopulmonary bypass
Guay, J, Kopp, S · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
32
current version
GRADE rated
18
No studies
14
Included studies
NR
No studies 14 · 43.8%Ungraded 0 · 0%Very low 8 · 25%Low 7 · 21.9%Moderate 3 · 9.4%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyEpidural analgesia compared with systemic analgesia for cardiac surgery with or without cardiopulmonary bypass in adults
Population: adults undergoing cardiac surgery with or without cardiopulmonary bypass
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality (0 to 30 days) Epidural analgesia vs systemic analgesia | RD 0 | 38 studies · 3418 participants | Low Downgraded: risk of bias, imprecision |
Myocardial infarction (0 to 30 days) Epidural analgesia vs systemic analgesia | no estimate extracted | 26 studies · 2713 participants | Low Downgraded: risk of bias, imprecision |
Pulmonary complications (0 to 30 days) Epidural analgesia vs systemic analgesia | no estimate extracted | 21 studies · 1736 participants | Low Downgraded: risk of bias, publication bias |
Atrial fibrillation or atrial flutter (0 to 2 weeks) Epidural analgesia vs systemic analgesia | no estimate extracted | 18 studies · 2431 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Risk of neurological complications (0 to 30 days) Epidural analgesia vs systemic analgesia | no estimate extracted | 18 studies · 2232 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Duration of tracheal intubation Epidural analgesia vs systemic analgesia | no estimate extracted | 40 studies · 3353 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Pain at rest at 6 to 8 hours after surgery Epidural analgesia vs systemic analgesia | no estimate extracted | 10 studies · 502 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Haemodynamic support (in hospital) Epidural analgesia vs systemic analgesia | RD 0.21 [0.09, 0.33] | 17 studies · 870 participants | Low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Epidural analgesia compared with peripheral nerve blocks for cardiac surgery in adult
Population: adults undergoing cardiac surgery without cardiopulmonary bypass
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortallity (0 to 30 days Epidural analgesia vs peripheral nerve blocks | no estimate extracted | 1 study · 145 participants | Very low Downgraded: risk of bias, imprecision |
Myocardial infarction (0 to 30 days) Epidural analgesia vs peripheral nerve blocks | RD 0 | 2 studies · 76 participants | Very low Downgraded: risk of bias, imprecision |
Pulmonary complications (0 to 30 days) Epidural analgesia vs peripheral nerve blocks | no estimate extracted | NR | No studies |
Atrial fibrillation or atrial flutter (0 to 2 weeks) Epidural analgesia vs peripheral nerve blocks | no estimate extracted | NR | No studies |
Risk of neurological complications (0 to 30 days) Epidural analgesia vs peripheral nerve blocks | no estimate extracted | NR | No studies |
Duration of tracheal intubation Epidural analgesia vs peripheral nerve blocks | no estimate extracted | 4 studies · 271 participants | Very low Downgraded: risk of bias, imprecision |
Pain at rest at 6 to 8hours after surgery (score from 0 to 10) Epidural analgesia vs peripheral nerve blocks | MD 0.12 | 2 studies · 90 participants | Very low Downgraded: risk of bias, imprecision |
Haemodynamic support (in hospital) Epidural analgesia vs peripheral nerve blocks | RD 0.05 | 1 study · 40 participants | Low Downgraded: risk of bias, imprecision |
Epidural analgesia compared with intrapleural analgesia for cardiac surgery in adults
Population: adults undergoing cardiac surgery without cardiopulmonary bypass
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality (0 to 30 days) Epidural analgesia vs intrapleural analgesia | no estimate extracted | NR | No studies |
Myocardial infarction (0 to 30 days) Epidural analgesia vs intrapleural analgesia | RD 0 | 1 study · 50 participants | Low Downgraded: imprecision |
Pulmonary complications (0 to 30 days) Epidural analgesia vs intrapleural analgesia | no estimate extracted | NR | No studies |
Atrial fibrillation or atrial flutter) (0 to 2 weeks) Epidural analgesia vs intrapleural analgesia | no estimate extracted | NR | No studies |
Risk of neurologicalcomplications (0 to 30 days) Epidural analgesia vs intrapleural analgesia | no estimate extracted | NR | No studies |
Duration of tracheal intubation Epidural analgesia vs intrapleural analgesia | no estimate extracted | 1 study · 15 participants | Very low Downgraded: risk of bias, imprecision |
Pain at rest at 6 to 8 hours (score from 0 to 10) Epidural analgesia vs intrapleural analgesia | MD 0.84 [0.31, 1.37] | 1 study · 50 participants | Low Downgraded: imprecision |
Haemodynamic support (in hospital) Epidural analgesia vs intrapleural analgesia | no estimate extracted | NR | No studies |
Epidural analgesia compared with wound infiltration for cardiac surgery in adults
Population: adults undergoing cardiac surgery without cardiopulmonary bypass
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortallity (0 to 30 days) Epidural analgesia vs wound infiltration | no estimate extracted | NR | No studies |
Myocardial infarction (0 to 30 days) Epidural analgesia vs wound infiltration | no estimate extracted | NR | No studies |
Pulmonary complications (0 to 30 days) Epidural analgesia vs wound infiltration | no estimate extracted | NR | No studies |
Atrial fibrillation or atrial flutter (0 to 2 weeks) Epidural analgesia vs wound infiltration | no estimate extracted | NR | No studies |
Risk of neurologicalcomplications (0 to 30 days) Epidural analgesia vs wound infiltration | no estimate extracted | NR | No studies |
Duration of tracheal intubation Epidural analgesia vs wound infiltration | no estimate extracted | 37 participants | Very low Downgraded: risk of bias, imprecision |
Pain at rest at 6 to 8 hours (score from 0 to 10) Epidural analgesia vs wound infiltration | no estimate extracted | 37 participants | Very low Downgraded: risk of bias, imprecision |
Haemodynamic support (in hospital) Epidural analgesia vs wound infiltration | no estimate extracted | NR | No studies |
Epidural analgesia for cardiac surgery
Population: adult patients undergoing cardiac surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
respiratory complications | no estimate extracted | 14 studies · 2011 participants | Ungraded |
supraventricular arrhythmias | no estimate extracted | 15 studies · 2250 participants | Ungraded |
mortality | no estimate extracted | 31 studies · 2877 participants | Ungraded |
myocardial infarction | no estimate extracted | 17 studies · 2127 participants | Ungraded |
stroke | no estimate extracted | 10 studies · 1791 participants | Ungraded |