Study/Patient Characteristics Neuraxial versus General Anesthesia
Randomized Clinical Trials
Table 1. Study and patient characteristics.
| Characteristic [37 trials] |
Mean Med (Range) or N (%) |
|---|---|
| Patients enrolled | 184 80 (25 - 1,600) |
| Arms, N (%) | |
| 2 | 31 (83.8) |
| 3 | 5 (13.5) |
| 4 | 1 (2.7) |
| Pilot study, N (%) | 3 (8.1) |
| Ambulatory, N (%) | 0 (0.0) |
| Centers, N (%) | |
| 1 | 34 (91.9) |
| 9 | 1 (2.7) |
| 12 | 1 (2.7) |
| 46 | 1 (2.7) |
| Country, N (%) | |
| China | 9 (24.3) |
| Italy | 4 (10.8) |
| Turkey | 3 (8.1) |
| USA | 3 (8.1) |
| Croatia | 2 (5.4) |
| Greece | 2 (5.4) |
| Sweden | 2 (5.4) |
| UK | 2 (5.4) |
| Australia | 1 (2.7) |
| Denmark | 1 (2.7) |
| France | 1 (2.7) |
| India | 1 (2.7) |
| Iran | 1 (2.7) |
| Japan | 1 (2.7) |
| Malta | 1 (2.7) |
| South Korea | 1 (2.7) |
| Thailand | 1 (2.7) |
| Ukraine | 1 (2.7) |
| Low resource country, N (%) | 12 (32.4) |
| Funding, N (%) | |
| Not reported | 16 (43.2) |
| Public | 15 (40.5) |
| None | 6 (16.2) |
| Author conflict of interest, N (%) | 3 (8.1) |
| Registered, N (%) | 14 (37.8) |
Surgery |
N = 37 |
|---|---|
| Procedure(s), N (%) | |
| Ortho | 20 (54) |
| Urol | 6 (16) |
| GI/Abdominal | 3 (8.1) |
| Neuro | 2 (5.4) |
| Gyn | 1 (2.7) |
| Gyn|Ortho|Urol|Vasc | 1 (2.7) |
| Other | 1 (2.7) |
| Spine | 1 (2.7) |
| Variousa | 1 (2.7) |
| Vasc | 1 (2.7) |
| a If reported as various/mixed or included more than 4 types of procedures. | |
| Characteristic | Na | Mean Med (Range) or N (%) |
|---|---|---|
| Age (mean/med) | 36 | 70.4 68.7 (60.5 - 84.1) |
| BMI (mean/med) | 10 | 26.0 24.9 (21.6 - 33.5) |
| Female (%) | 33 | 50.5 53.5 (0.0 - 100.0) |
| ASA Physical Status, N (%) | 23 | |
| 12 | 3 (13.0) | |
| 123 | 12 (52.2) | |
| 1234 | 5 (21.7) | |
| 23 | 3 (13.0) | |
| White (%) | 2 | 90.1 (89.4 - 90.8) |
| Black (%) | 2 | 8.6 (8.0 - 9.2) |
| Asian (%) | 7 | all 100 |
| Preop MMSE (mean/med) | 10 | 25.2 26.2 (20.0 - 28.5) |
| Cognitive Impairment (%) | 18 | 3.8 0.0 (0.0 - 39.5) |
| Diabetes (%) | 14 | 24.3 21.1 (10.5 - 61.6) |
| Cardiac (%) | 15 | 18.9 14.8 (0.0 - 61.6) |
| a N of the 37 studies reporting characteristic allowing description. | ||
Outcomes
Table 2. Primary, secondard, and other outcomes.
| Primary Outcome | RCT, N = 37a |
|---|---|
| Postoperative delirium | 6 (16%) |
| Neurocognitive disorder <30 days | 9 (24%) |
| Patient/caregiver satisfaction | 4 (11%) |
| Functional status (ADL, IADL, mobility) | 5 (14%) |
| Pain | 14 (38%) |
| Opioid use | 4 (11%) |
| Complications | 6 (16%) |
| Length of stay | 5 (14%) |
| Mortality (30-, 180-, 365-day) | 1 (2.7%) |
| Other | 8 (22%)b |
| a n (%) | |
| b “[A]cceptibility, efficacy, and reliability” of general versus spinal anesthesia. Surgery time; blood loss; hemodynamics. Laboratory results. Composite of death or an inability to walk 10ft or across a room independently or with a walker/cane but without the assistance of another person at 60 days postop. Hemodynamic changes; PONV. Hypotension; heart rate; bradycardia; PACU discharge. Perioperative blood loss; time to first meal; time to first ambulation. Analgesic Requirements; length of PACU stay. |
|
| Secondary Outcome | RCT, N = 37a |
|---|---|
| Postoperative delirium | 2 (5.4%) |
| Neurocognitive disorder <30 days | 1 (2.7%) |
| Patient/caregiver satisfaction | 3 (8.1%) |
| Functional status (ADL, IADL, mobility) | 2 (5.4%) |
| HRQoL | 1 (2.7%) |
| Pain | 4 (11%) |
| Opioid use | 5 (14%) |
| Complications | 4 (11%) |
| Length of stay | 4 (11%) |
| Readmission | 1 (2.7%) |
| Mortality (30-, 180-, 365-day) | 3 (8.1%) |
| Other | 5 (14%)b |
| a n (%) | |
| b Laboratory results for acute inflammation. Biomarkers. Sleep quality; mobilization time. Ambulation at 60 days. Hemodynamic parameters; side effects. |
|
| Other Outcome | RCT, N = 37a |
|---|---|
| Postoperative delirium | 1 (2.7%) |
| Neurocognitive disorder <30 days | 1 (2.7%) |
| Depression | 1 (2.7%) |
| Patient/caregiver satisfaction | 1 (2.7%) |
| Pain | 1 (2.7%) |
| Opioid use | 2 (5.4%) |
| Complications | 4 (11%) |
| Length of stay | 2 (5.4%) |
| a n (%) | |