Summary of findings 3. Thiopentone with and without added hypnotic drugs (ketamine, etomidate).
| Thiopentone with and without added hypnotic drugs (ketamine, etomidate) | ||||||
| Patient or population: patients with prevention of recall of events during surgery Settings: All patients undergoing various surgical procedures in hospitals in Europe/Australia/Asia/Middle East/North America Intervention: anaesthetic drugs introduced after thiopentone for prevention of recall of events during surgery Comparison: Thiopentone with and without added hypnotic drugs (ketamine, etomidate) | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Thiopentone | Anaesthetic drugs introduced after thiopentone for prevention of recall of events during surgery: Ketamine, etomidate | |||||
| Intraoperative Wakefulness Postoperative Interview Follow‐up: 0 to 7 days | 552 per 1000 | 99 per 1000 (50 to 226) | RR 0.18 (0.09 to 0.41) | 141 (3 studies) | ⊕⊕⊝⊝ low1,2 | — |
|
Adverse effects of intraoperative wakefulness and/or postoperative awareness (i.e. post‐traumatic stress syndrome, myocardial infarction, cardiac arrest, etc.) |
— | — | — | — | — | Not defined or not identified |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. 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). CI: confidence interval; RR: risk ratio | ||||||
| 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. | ||||||
1Within‐study risk of bias: downgraded one level. 2Imprecision of results: downgraded one level for imprecision of effect. The high proportion of wakefulness events to sample size in these small studies was the reason for the one level downgrade compared to two levels for Comparison 4 and 5. The optimal information size threshold cannot be reached.