Cardiothoracic & vascular anesthesia
A systematic review and meta-analysis of thoracic epidural analgesia versus other analgesic techniques in patients post-oesophagectomy
Pooled result · PPCs (composite)Result — go to the resultRelative risk 3.88 95% CI 1.98–7.61Authors' conclusion
Despite these limitations, current evidence indicates that thoracic epidural analgesia reduces the risk of PPCs and severe pain, compared to intravenous opioids in patients following oesophageal cancer surgery.
Study context
- Population
- Patients undergoing oesophagectomy (9 trials open surgery, 1 laparoscopic)
- Participants
- 741 patients · 10 randomised controlled trials (RCTs)
- Comparison
- Thoracic epidural analgesia (TEA) vs IV opioids
- Outcome
- Composite of:
- Respiratory infection
- Atelectasis
- Respiratory failure (postoperative pulmonary complications (PPCs))
Methodological detailsrandom effect models, prospectively registered
- Random effect models
- Prospectively registered
Pooled result
PPCs (composite)
Relative risk
3.88
95% CI 1.98–7.61
TEA vs Intravenous opioids
RR 3.88 (95% CI 1.98–7.61)
As reported in the abstract
Further pooled results
| Outcome | MD (95% CI) | |
|---|---|---|
| Pain at rest (0-100-mm VAS) · 24 hn = 685; 10 RCTs | 9.02 (5.88–12.17) | |
| Pain at rest (0-100-mm VAS) · 48 hn = 685; 10 RCTs | 8.64 (5.91–11.37) | |
| Pain on movement (0-100-mm VAS) · 24 hn = 275; 4 RCTs | 14.96 (5.46–24.46) | |
| Pain on movement (0-100-mm VAS) · 48 hn = 275; 4 RCTs | 16.60 (8.72–24.47) | |
| −100102030Difference (linear scale) |
Original publication
A systematic review and meta-analysis of thoracic epidural analgesia versus other analgesic techniques in patients post-oesophagectomy. Perioper Med (Lond). Published 23 July 2024. doi:10.
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