Table 1.
Summary of RCTs included in the meta-analysis
| First author/Year of publication | No. of subjects | Surgery type | CABG technology | TEA continued postoperatively | TEA | Perioperative management of TEA | Primary endpoint? |
POAF |
Study design/Jadad score | |
|---|---|---|---|---|---|---|---|---|---|---|
| TEA + GA | GA | |||||||||
| Jidéus/2001 [15] |
121 |
elective CABG |
CPB |
Unclear |
T2-T5, the day before surgery |
Intraoperative: bupivacaine 5 mg/mL, with an infusion rate of 4 to 8 mL/h. Postoperative: continuous infusion of bupivacaine (2 mg/mL) and sufentanil (1 mg/mL) epidurally (3 to 7 mL/h) |
Yes |
13/41 |
29/80 |
RCT/2 |
| Nygard/2004 [16] |
163 |
elective CABG |
CPB |
4 days |
T1-T3, the day before surgery |
Intraoperative and postoperative : bolus doses of 4 mL of bupivacaine, 5 mg/mL, given hourly |
Yes |
28/79 |
25/84 |
RCT/3 |
| Bakhtiary/2007 [17] |
132 |
elective CABG |
OPCAB |
3 days |
T1-T3, the day before surgery |
Preoperative and postoperative: continuous infusion with ropivacaine 0.16 % and sufentanil 1 g/mL at an hourly rate of 2 to 5 mL was started after a bolus dose of 6 mL |
Yes |
2/66 |
18/66 |
RCT/2 |
| Tenenbein/2008 [18] |
50 |
elective or semi-elective CABG |
CPB |
2 days |
T2-T5, at least four hours prior to systemic heparinization |
Intraoperative: 5-mL bolus of 0.75% ropivacaine and 200 μg of hydromorphone in the epidural catheter, followed by infusion of 0.75 % ropivacaine at 5 mL/h. Postoperative: continuous infusion lasting 48 h and consisting of 0.2 % ropivacaine, with 15 μg/mL of hydromorphone titrated. |
No |
6/25 |
9/25 |
RCT/3 |
| Caputo/2009 [19] | 74 | elective CABG | OPCAB | 3 days | T2-T4, before induction of anesthesia | Intraoperative and postoperative: continuous infusion of 0.125 % bupivacaine and 0.0003 % clonidine (150 g in 500 mL) at an initial rate of 10 mL/h | No | 7/36 | 18/38 | RCT/3 |
CABG, coronary artery bypass surgery; OPCAB, off-pump coronary artery bypass grafting; CPB, cardiopulmonary bypass; TEA, thoracic epidural anesthesia; GA, general anesthesia; POAF, postoperative atrial fibrillation; RCT, randomized controlled trial.