Summary of findings 3. Epidural analgesia compared with intrapleural analgesia for cardiac surgery in adults.
| Epidural analgesia compared with intrapleural analgesia for cardiac surgery in adults | ||||||
|
Patient or population: adults undergoing cardiac surgery without cardiopulmonary bypass Settings: university hospital in India Intervention: epidural analgesia Comparison: intrapleural analgesia | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Risk difference or relative effect (95% CI) | No. of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Intrapleural analgesia | Epidural analgesia | |||||
|
Mortality (0 to 30 days) |
We found no data for this outcome | |||||
|
Myocardial infarction (0 to 30 days) |
Study population |
RD 0.00 (‐0.07 to 0.07) |
50 (1 study) |
⊕⊕⊝⊝ lowa |
||
| 0 per 1000 |
0 per 1000 (0 to 71) |
|||||
|
Pulmonary complications (0 to 30 days) |
We found no data for this outcome (respiratory depression or pneumonia) | |||||
| Atrial fibrillation or atrial flutter) (0 to 2 weeks) | We found no data for this outcome | |||||
|
Risk of neurological
complications (0 to 30 days) |
Cerebrovascular accident | |||||
| We found no data for this outcome | ||||||
| Epidural haematoma | ||||||
| Study population |
RD 0.00 (‐0.07 to 0.07) |
50 (1 study) |
⊕⊕⊝⊝ lowa |
|||
| 0 per 1000 | 0 per 1000 | |||||
| Duration of tracheal intubation | Study population |
MD ‐0.30 (‐1.20 to 0.60 hour) |
15 (1 study) |
⊕⊕⊝⊝ very lowb |
17 participants in the epidural analgesia group and 14 in the intrapleural analgesia group were extubated in the operating room Means and SDs given by study authors are those for the rest of the participants |
|
| 4.1 ± 0.59 hours (mean ± SD) |
3.8 ± 1.13 hours (mean ± SD) | |||||
|
Pain at rest at 6 to 8 hours (score from 0 to 10) |
Study population |
MD 0.84 (0.31 to 1.37) |
50 (1 study) |
⊕⊕⊝⊝ lowa |
||
| 4.52 ± 1.08 | 3.68 ± 0.82 | |||||
|
Haemodynamic support (in hospital) |
We found no data for this outcome | |||||
| *The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). Confidence intervals were calculated using VassarStats (http://www.vassarstats.net/). CI: confidence interval; MD: mean difference; RD: risk difference; SD: standard deviation. | ||||||
| GRADE Working Group grades of evidence. High quality: further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: we are very uncertain about the estimate. | ||||||
aDowngraded by two levels for imprecision.
bDowngraded by one level for risk of bias and by two levels for imprecision.