Cargando…
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...
Autores principales: | , , , , , , , , , , , , |
---|---|
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 |
_version_ | 1784699111459520512 |
---|---|
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. |
format | Online Article Text |
id | pubmed-9063185 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT bartelskarsten postoperativepulmonarycomplicationswithadjuvantregionalanesthesiaversusgeneralanesthesiaaloneasubanalysisoftheperioperativeresearchnetworkstudy AT frendlgyorgy postoperativepulmonarycomplicationswithadjuvantregionalanesthesiaversusgeneralanesthesiaaloneasubanalysisoftheperioperativeresearchnetworkstudy AT sprungjuraj postoperativepulmonarycomplicationswithadjuvantregionalanesthesiaversusgeneralanesthesiaaloneasubanalysisoftheperioperativeresearchnetworkstudy AT weingartentobyn postoperativepulmonarycomplicationswithadjuvantregionalanesthesiaversusgeneralanesthesiaaloneasubanalysisoftheperioperativeresearchnetworkstudy AT subramaniambalachundhar postoperativepulmonarycomplicationswithadjuvantregionalanesthesiaversusgeneralanesthesiaaloneasubanalysisoftheperioperativeresearchnetworkstudy AT martinezruizricardo postoperativepulmonarycomplicationswithadjuvantregionalanesthesiaversusgeneralanesthesiaaloneasubanalysisoftheperioperativeresearchnetworkstudy AT leejaewoo postoperativepulmonarycomplicationswithadjuvantregionalanesthesiaversusgeneralanesthesiaaloneasubanalysisoftheperioperativeresearchnetworkstudy AT hendersonwilliamg postoperativepulmonarycomplicationswithadjuvantregionalanesthesiaversusgeneralanesthesiaaloneasubanalysisoftheperioperativeresearchnetworkstudy AT mossangela postoperativepulmonarycomplicationswithadjuvantregionalanesthesiaversusgeneralanesthesiaaloneasubanalysisoftheperioperativeresearchnetworkstudy AT sodicksonalissa postoperativepulmonarycomplicationswithadjuvantregionalanesthesiaversusgeneralanesthesiaaloneasubanalysisoftheperioperativeresearchnetworkstudy AT giqueljadelis postoperativepulmonarycomplicationswithadjuvantregionalanesthesiaversusgeneralanesthesiaaloneasubanalysisoftheperioperativeresearchnetworkstudy AT vidalmelomarcosfrancisco postoperativepulmonarycomplicationswithadjuvantregionalanesthesiaversusgeneralanesthesiaaloneasubanalysisoftheperioperativeresearchnetworkstudy AT fernandezbustamanteana postoperativepulmonarycomplicationswithadjuvantregionalanesthesiaversusgeneralanesthesiaaloneasubanalysisoftheperioperativeresearchnetworkstudy AT postoperativepulmonarycomplicationswithadjuvantregionalanesthesiaversusgeneralanesthesiaaloneasubanalysisoftheperioperativeresearchnetworkstudy |