Hipotensión deliberada con propofol bajo anestesia para la cirugía funcional endoscópica de senos paranasales (CFES)
Información
- DOI:
- https://doi.org/10.1002/14651858.CD006623.pub3Copiar DOI
- Base de datos:
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- Cochrane Database of Systematic Reviews
- Versión publicada:
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- 12 octubre 2016see what's new
- Tipo:
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- Intervention
- Etapa:
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- Review
- Grupo Editorial Cochrane:
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Grupo Cochrane de Anestesia
- Copyright:
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- Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cifras del artículo
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Autores
Contributions of authors
Polpun Boonmak (PB), Suhattaya Boonmak (SB), Malinee Laopaiboon (ML)
Conceiving the review: PB, SB
Co‐ordinating the review: PB, BS, ML
Undertaking manual searches: PB, SB
Screening search results: PB, SB
Organizing retrieval of papers: PB, SB
Screening retrieved papers against inclusion criteria: PB, SB
Appraising quality of papers: PB, SB
Abstracting data from papers: PB, SB
Writing to authors of papers for additional information: PB, SB
Providing additional data about papers: PB, SB
Obtaining and screening data on unpublished studies: PB, SB
Providing data management for the review: PB, SB, ML
Entering data into Review Manager (RevMan 5.3): PB, SB
Obtaining RevMan statistical data: PB, SB, ML
Performing other statistical analysis while not using RevMan: ML
Performing double entry of data: (data entered by person one: PB; data entered by person two: SB)
Interpreting data: ML
Making statistical inferences: ML
Writing the review: PB, SB, ML
Securing funding for the review: PB
Performing previous work that served as the foundation of the present study: PB, SB
Serving as guarantor for the review (one author): PB
Taking responsibility for reading and checking review before submission: PB, SB
Sources of support
Internal sources
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Systematic review grant, Faculty of Medicine, Khon Kaen University, Thailand.
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Thai Cochrane Network, Thailand.
External sources
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The Thailand Research Fund, Thailand.
Declarations of interest
Polpun Boonmak: none known.
Suhattaya Boonmak: none known.
Malinee Laopaiboon: received an honorarium from Thailand Research Fund, a nonprofit organization, in 2014.
Acknowledgements
We would like to thank Jane Cracknell for her help and editorial advice during the preparation of this review update.
We would like to thank Mike Bennett (content editor) and James W Fairley and Leopold Eberhart (peer reviewers) for their help and editorial advice during the preparation of the protocol for this systematic review (Boonmak 2007). We also thank Karen Hovhannisyan for his search strategy and data searching.
We would like to thank Jane Cracknell, Mike Bennett (content editor), Marialena Trivella (statistical editor), James W Fairley and Leopold Eberhart (peer reviewers), and Katriona Methven (representative of the Cochrane Consumer Network) for their help and editorial advice during the preparation of the previous version of this review (Boonmak 2013).
Version history
| Published | Title | Stage | Authors | Version |
| 2016 Oct 12 | Deliberate hypotension with propofol under anaesthesia for functional endoscopic sinus surgery (FESS) | Review | Polpun Boonmak, Suhattaya Boonmak, Malinee Laopaiboon | |
| 2013 Jun 06 | Deliberate hypotension with propofol under anaesthesia for functional endoscopic sinus surgery (FESS) | Review | Suhattaya Boonmak, Polpun Boonmak, Malinee Laopaiboon | |
| 2007 Jul 18 | Deliberate hypotension with propofol under anaesthesia for functional endoscopic sinus surgery (FESS) | Protocol | Suhattaya Boonmak, Polpun Boonmak, Malinee Laopaiboon | |
Differences between protocol and review
We made the following changes to the protocol (Boonmak 2007).
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The quality of surgical field grading was changed from "good, fair, poor" to 6‐point scale surgical field.
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Principal author in this update (2016) is Polpun Boonmak.
Keywords
MeSH
Medical Subject Headings (MeSH) Keywords
Medical Subject Headings Check Words
Adult; Child; Humans;
PICO
Study flow diagram.
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Comparison 1 Propofol versus inhalation anaesthetics, Outcome 1 Quality of surgical field (age group).
Comparison 1 Propofol versus inhalation anaesthetics, Outcome 2 Operation time (minutes).
| Propofol versus inhalation anaesthetics for functional endoscopic sinus surgery (FESS) | ||||||
| Patient or population: patients undergoing FESS | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of Participants | Quality of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Propofol versus inhalation anaesthetics | |||||
| Total blood loss ‐ children | The mean total blood loss was 120 mL | The mean total blood loss was 20 lower (0.77 to 39.23 lower) | 70 (1 study) | ⊕⊝⊝⊝ | ||
| Total blood loss ‐ adults | The median total blood loss was 170 mL | The median total blood loss was 100 mL (interquartile range 50 to 240 mL) | 88 (1 study) | ⊕⊕⊕⊝ | ||
| Quality of surgical field | The mean quality of surgical field in the control groups was | The mean quality of surgical field in the intervention groups was | 277 | ⊕⊕⊝⊝ | ||
| Operation time | The mean operation time in the control groups was 91.51 min | The mean operation time in the intervention groups was | 214 | ⊕⊕⊝⊝ | ||
| Failure of deliberate hypotension (%) | 372 per 1000 | 89 per 1000 | RR 0.24 | 88 | ⊕⊕⊕⊝ | |
| *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). | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1Downgraded three levels due to concerns about random sequence generation, allocation concealment and very wide confidence interval for the difference. 2Downgraded one level due to concerns about random sequence generation. 3Downgraded two levels due to serious concerns about random sequence generation, and allocation concealment. 4Downgraded two levels due to serious concerns about random sequence generation, and allocation concealment. | ||||||
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Quality of surgical field (age group) Show forest plot | 4 | 277 | Mean Difference (IV, Random, 95% CI) | ‐0.64 [‐0.91, ‐0.37] |
| 1.1 Adult | 3 | 207 | Mean Difference (IV, Random, 95% CI) | ‐0.75 [‐1.10, ‐0.40] |
| 1.2 Children | 1 | 70 | Mean Difference (IV, Random, 95% CI) | ‐0.40 [‐0.64, ‐0.16] |
| 2 Operation time (minutes) Show forest plot | 3 | 214 | Mean Difference (IV, Fixed, 95% CI) | ‐4.81 [‐11.82, 2.21] |
| 2.1 Adult | 2 | 144 | Mean Difference (IV, Fixed, 95% CI) | 3.89 [‐9.64, 17.42] |
| 2.2 Children | 1 | 70 | Mean Difference (IV, Fixed, 95% CI) | ‐8.0 [‐16.20, 0.20] |
