The Impact of Regional Nerve Blocks on Postoperative Delirium or Cognitive Dysfunction following Thoracic Surgery: A Systematic Review and Meta-Analysis
Regional nerve blocks (NBs) mitigate the occurrence of postoperative cognitive dysfunction (POCD) and postoperative delirium (POD) in adult patients undergoing thoracic surgery. This study aimed to determine the exact effect of NBs on POCD and POD. Electronic databases, including PubMed, EMBASE, CIN...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/24/7576 |
| _version_ | 1797380528957030400 |
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| author | Su Yeon Kim Jiyoun Lee Hyo-Seok Na Bon-Wook Koo Keum O Lee Hyun-Jung Shin |
| author_facet | Su Yeon Kim Jiyoun Lee Hyo-Seok Na Bon-Wook Koo Keum O Lee Hyun-Jung Shin |
| author_sort | Su Yeon Kim |
| collection | DOAJ |
| description | Regional nerve blocks (NBs) mitigate the occurrence of postoperative cognitive dysfunction (POCD) and postoperative delirium (POD) in adult patients undergoing thoracic surgery. This study aimed to determine the exact effect of NBs on POCD and POD. Electronic databases, including PubMed, EMBASE, CINAHL, Scopus, and Web of Science, were searched for studies. The primary outcome was the incidence of POD or POCD. The secondary outcome was pain scores assessed 24 and 48 h postoperatively. We calculated the log odds ratio (LOR) and standardized mean difference (SMD) with 95% confidence intervals (CIs). The LOR was converted to an odds ratio (OR). In the analysis of 1010 patients from seven randomized controlled trials, POD and POCD rates were 14.1% and 16.7%, respectively, in the NB group, and higher, at 27.3% and 35.2%, in the control group. NBs reduced the incidence of POD (OR, 0.44; 95%CI 0.30 to 0.64; <i>p</i> < 0.001; I<sup>2</sup> = 0.00%) and POCD (OR, 0.43; 95%CI 0.24 to 0.76; <i>p</i> < 0.001; I<sup>2</sup> = 0.00%). NBs reduced pain scores at 24 h (SMD, −2.60; 95%CI −3.90 to −1.30, <i>p</i> < 0.001; I<sup>2</sup> = 97.68%) and 48 h (SMD, −1.80; 95%CI −3.18 to −0.41, <i>p</i> = 0.01; I<sup>2</sup> = 98.14%) postoperatively. NBs mitigated the occurrence of POD and POCD in adult patients after thoracic surgery. |
| first_indexed | 2024-03-08T20:38:35Z |
| format | Article |
| id | doaj.art-22c788c5860444fb8370b1083223988c |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T20:38:35Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-22c788c5860444fb8370b1083223988c2023-12-22T14:17:03ZengMDPI AGJournal of Clinical Medicine2077-03832023-12-011224757610.3390/jcm12247576The Impact of Regional Nerve Blocks on Postoperative Delirium or Cognitive Dysfunction following Thoracic Surgery: A Systematic Review and Meta-AnalysisSu Yeon Kim0Jiyoun Lee1Hyo-Seok Na2Bon-Wook Koo3Keum O Lee4Hyun-Jung Shin5Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of KoreaRegional nerve blocks (NBs) mitigate the occurrence of postoperative cognitive dysfunction (POCD) and postoperative delirium (POD) in adult patients undergoing thoracic surgery. This study aimed to determine the exact effect of NBs on POCD and POD. Electronic databases, including PubMed, EMBASE, CINAHL, Scopus, and Web of Science, were searched for studies. The primary outcome was the incidence of POD or POCD. The secondary outcome was pain scores assessed 24 and 48 h postoperatively. We calculated the log odds ratio (LOR) and standardized mean difference (SMD) with 95% confidence intervals (CIs). The LOR was converted to an odds ratio (OR). In the analysis of 1010 patients from seven randomized controlled trials, POD and POCD rates were 14.1% and 16.7%, respectively, in the NB group, and higher, at 27.3% and 35.2%, in the control group. NBs reduced the incidence of POD (OR, 0.44; 95%CI 0.30 to 0.64; <i>p</i> < 0.001; I<sup>2</sup> = 0.00%) and POCD (OR, 0.43; 95%CI 0.24 to 0.76; <i>p</i> < 0.001; I<sup>2</sup> = 0.00%). NBs reduced pain scores at 24 h (SMD, −2.60; 95%CI −3.90 to −1.30, <i>p</i> < 0.001; I<sup>2</sup> = 97.68%) and 48 h (SMD, −1.80; 95%CI −3.18 to −0.41, <i>p</i> = 0.01; I<sup>2</sup> = 98.14%) postoperatively. NBs mitigated the occurrence of POD and POCD in adult patients after thoracic surgery.https://www.mdpi.com/2077-0383/12/24/7576deliriumnerve blockpostoperative cognitive dysfunction |
| spellingShingle | Su Yeon Kim Jiyoun Lee Hyo-Seok Na Bon-Wook Koo Keum O Lee Hyun-Jung Shin The Impact of Regional Nerve Blocks on Postoperative Delirium or Cognitive Dysfunction following Thoracic Surgery: A Systematic Review and Meta-Analysis Journal of Clinical Medicine delirium nerve block postoperative cognitive dysfunction |
| title | The Impact of Regional Nerve Blocks on Postoperative Delirium or Cognitive Dysfunction following Thoracic Surgery: A Systematic Review and Meta-Analysis |
| title_full | The Impact of Regional Nerve Blocks on Postoperative Delirium or Cognitive Dysfunction following Thoracic Surgery: A Systematic Review and Meta-Analysis |
| title_fullStr | The Impact of Regional Nerve Blocks on Postoperative Delirium or Cognitive Dysfunction following Thoracic Surgery: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Impact of Regional Nerve Blocks on Postoperative Delirium or Cognitive Dysfunction following Thoracic Surgery: A Systematic Review and Meta-Analysis |
| title_short | The Impact of Regional Nerve Blocks on Postoperative Delirium or Cognitive Dysfunction following Thoracic Surgery: A Systematic Review and Meta-Analysis |
| title_sort | impact of regional nerve blocks on postoperative delirium or cognitive dysfunction following thoracic surgery a systematic review and meta analysis |
| topic | delirium nerve block postoperative cognitive dysfunction |
| url | https://www.mdpi.com/2077-0383/12/24/7576 |
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