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Postoperative pulmonary complications with adjuvant regional anesthesia versus general anesthesia alone: a sub-analysis of the Perioperative Research Network study

BACKGROUND: Adjuvant regional anesthesia is often selected for patients or procedures with high risk of pulmonary complications after general anesthesia. The benefit of adjuvant regional anesthesia to reduce postoperative pulmonary complications remains uncertain. In a prospective observational mult...

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Autores principales: Bartels, Karsten, Frendl, Gyorgy, Sprung, Juraj, Weingarten, Toby N., Subramaniam, Balachundhar, Martinez Ruiz, Ricardo, Lee, Jae-Woo, Henderson, William G., Moss, Angela, Sodickson, Alissa, Giquel, Jadelis, Vidal Melo, Marcos Francisco, Fernandez-Bustamante, Ana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9063185/
https://www.ncbi.nlm.nih.gov/pubmed/35501692
http://dx.doi.org/10.1186/s12871-022-01679-5
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author Bartels, Karsten
Frendl, Gyorgy
Sprung, Juraj
Weingarten, Toby N.
Subramaniam, Balachundhar
Martinez Ruiz, Ricardo
Lee, Jae-Woo
Henderson, William G.
Moss, Angela
Sodickson, Alissa
Giquel, Jadelis
Vidal Melo, Marcos Francisco
Fernandez-Bustamante, Ana
author_facet Bartels, Karsten
Frendl, Gyorgy
Sprung, Juraj
Weingarten, Toby N.
Subramaniam, Balachundhar
Martinez Ruiz, Ricardo
Lee, Jae-Woo
Henderson, William G.
Moss, Angela
Sodickson, Alissa
Giquel, Jadelis
Vidal Melo, Marcos Francisco
Fernandez-Bustamante, Ana
author_sort Bartels, Karsten
collection PubMed
description BACKGROUND: Adjuvant regional anesthesia is often selected for patients or procedures with high risk of pulmonary complications after general anesthesia. The benefit of adjuvant regional anesthesia to reduce postoperative pulmonary complications remains uncertain. In a prospective observational multicenter study, patients scheduled for non-cardiothoracic surgery with at least one postoperative pulmonary complication surprisingly received adjuvant regional anesthesia more frequently than those with no complications. We hypothesized that, after adjusting for surgical and patient complexity variables, the incidence of postoperative pulmonary complications would not be associated with adjuvant regional anesthesia. METHODS: We performed a secondary analysis of a prospective observational multicenter study including 1202 American Society of Anesthesiologists physical status 3 patients undergoing non-cardiothoracic surgery. Patients were classified as receiving either adjuvant regional anesthesia or general anesthesia alone. Predefined pulmonary complications within the first seven postoperative days were prospectively identified. Groups were compared using bivariable and multivariable hierarchical logistic regression analyses for the outcome of at least one postoperative pulmonary complication. RESULTS: Adjuvant regional anesthesia was performed in 266 (22.1%) patients and not performed in 936 (77.9%). The incidence of postoperative pulmonary complications was greater in patients receiving adjuvant regional anesthesia (42.1%) than in patients without it (30.9%) (site adjusted p = 0.007), but this association was not confirmed after adjusting for covariates (adjusted OR 1.37; 95% CI, 0.83–2.25; p = 0.165). CONCLUSION: After adjusting for surgical and patient complexity, adjuvant regional anesthesia versus general anesthesia alone was not associated with a greater incidence of postoperative pulmonary complications in this multicenter cohort of non-cardiothoracic surgery patients.
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spelling pubmed-90631852022-05-04 Postoperative pulmonary complications with adjuvant regional anesthesia versus general anesthesia alone: a sub-analysis of the Perioperative Research Network study Bartels, Karsten Frendl, Gyorgy Sprung, Juraj Weingarten, Toby N. Subramaniam, Balachundhar Martinez Ruiz, Ricardo Lee, Jae-Woo Henderson, William G. Moss, Angela Sodickson, Alissa Giquel, Jadelis Vidal Melo, Marcos Francisco Fernandez-Bustamante, Ana BMC Anesthesiol Research BACKGROUND: Adjuvant regional anesthesia is often selected for patients or procedures with high risk of pulmonary complications after general anesthesia. The benefit of adjuvant regional anesthesia to reduce postoperative pulmonary complications remains uncertain. In a prospective observational multicenter study, patients scheduled for non-cardiothoracic surgery with at least one postoperative pulmonary complication surprisingly received adjuvant regional anesthesia more frequently than those with no complications. We hypothesized that, after adjusting for surgical and patient complexity variables, the incidence of postoperative pulmonary complications would not be associated with adjuvant regional anesthesia. METHODS: We performed a secondary analysis of a prospective observational multicenter study including 1202 American Society of Anesthesiologists physical status 3 patients undergoing non-cardiothoracic surgery. Patients were classified as receiving either adjuvant regional anesthesia or general anesthesia alone. Predefined pulmonary complications within the first seven postoperative days were prospectively identified. Groups were compared using bivariable and multivariable hierarchical logistic regression analyses for the outcome of at least one postoperative pulmonary complication. RESULTS: Adjuvant regional anesthesia was performed in 266 (22.1%) patients and not performed in 936 (77.9%). The incidence of postoperative pulmonary complications was greater in patients receiving adjuvant regional anesthesia (42.1%) than in patients without it (30.9%) (site adjusted p = 0.007), but this association was not confirmed after adjusting for covariates (adjusted OR 1.37; 95% CI, 0.83–2.25; p = 0.165). CONCLUSION: After adjusting for surgical and patient complexity, adjuvant regional anesthesia versus general anesthesia alone was not associated with a greater incidence of postoperative pulmonary complications in this multicenter cohort of non-cardiothoracic surgery patients. BioMed Central 2022-05-03 /pmc/articles/PMC9063185/ /pubmed/35501692 http://dx.doi.org/10.1186/s12871-022-01679-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Bartels, Karsten
Frendl, Gyorgy
Sprung, Juraj
Weingarten, Toby N.
Subramaniam, Balachundhar
Martinez Ruiz, Ricardo
Lee, Jae-Woo
Henderson, William G.
Moss, Angela
Sodickson, Alissa
Giquel, Jadelis
Vidal Melo, Marcos Francisco
Fernandez-Bustamante, Ana
Postoperative pulmonary complications with adjuvant regional anesthesia versus general anesthesia alone: a sub-analysis of the Perioperative Research Network study
title Postoperative pulmonary complications with adjuvant regional anesthesia versus general anesthesia alone: a sub-analysis of the Perioperative Research Network study
title_full Postoperative pulmonary complications with adjuvant regional anesthesia versus general anesthesia alone: a sub-analysis of the Perioperative Research Network study
title_fullStr Postoperative pulmonary complications with adjuvant regional anesthesia versus general anesthesia alone: a sub-analysis of the Perioperative Research Network study
title_full_unstemmed Postoperative pulmonary complications with adjuvant regional anesthesia versus general anesthesia alone: a sub-analysis of the Perioperative Research Network study
title_short Postoperative pulmonary complications with adjuvant regional anesthesia versus general anesthesia alone: a sub-analysis of the Perioperative Research Network study
title_sort postoperative pulmonary complications with adjuvant regional anesthesia versus general anesthesia alone: a sub-analysis of the perioperative research network study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9063185/
https://www.ncbi.nlm.nih.gov/pubmed/35501692
http://dx.doi.org/10.1186/s12871-022-01679-5
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