التفاصيل البيبلوغرافية
| العنوان: |
Does caudal analgesia increase the rates of urethrocutaneous fistula formation after hypospadias repair? Systematic review and meta-analysis. |
| المؤلفون: |
Goel, Prabudh, Jain, Shikha, Bajpai, Minu, Khanna, Puneet, Jain, Vishesh, Yadav, Devendra |
| المصدر: |
Indian Journal of Urology; Jul-Sep2019, Vol. 35 Issue 3, p222-229, 8p |
| مصطلحات موضوعية: |
URINARY fistula, CONFIDENCE intervals, UROLOGICAL surgery, HYPOSPADIAS, MEDICAL databases, INFORMATION storage & retrieval systems, MEDLINE, META-analysis, ONLINE information services, EPIDURAL anesthesia, SURGICAL complications, SYSTEMATIC reviews, RELATIVE medical risk, ODDS ratio, DISEASE risk factors |
| مستخلص: |
Introduction: Caudal block analgesia is administered to lower the requirements of systemic and inhaled anesthetic drugs during hypospadias surgery. However, recent reports, all clustered in a short time-span have generated controversial and mutually opposing results while evaluating caudal block as an independent risk factor for urethroplasty-related complications after hypospadias repair. There is no consensus statement on the role of caudal block analgesia in formation of urethrocutaneous fistula (UCF) after hypospadias surgery. We performed a systematic review and meta-analysis of the studies evaluating the relative rates of UCF formation after hypospadias surgery in patients who were administered caudal block analgesia versus in those who were not. Methods: Electronic searches were performed using PubMed, PubMed Central, Google Scholar, Ovid, and the Cochrane library. Statistical analysis was performed using a fixed-effect model, odds ratios, risk ratios (RR), and heterogeneity (I2) were calculated. Funnel plot was used to assess for publication bias. Results: Seven studies with 1706 patients were included. Caudal block analgesia is associated with a significantly higher risk of UCF formation (RR: 1.81; 95% confidence interval [CI]: 1.30–2.53), (P = 0.0004) and other urethroplasty-related complications (RR 2.01; 95% CI: 1.48–2.74), (P < 0.00001) after hypospadias surgery. Funnel plots indicate some publication bias. Conclusions: In patients undergoing hypospadias repair, administration of caudal analgesia is associated with a higher risk of UCF formation and other urethroplasty-related complications. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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