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LETTER TO THE EDITOR

Prior Work Using Meta-Analyses of Operative Times Between Regional and General Anesthesia

Departments of Anesthesia and Health Management and Policy; University of Iowa; Iowa City, IA; Franklin-Dexter{at}UIowa.edu or www.FranklinDexter.net

To the Editor:

Mauermann et al. (1) explain that: "A recent meta-analysis showed that compared with general anesthesia, neuraxial block reduced many serious complications in patients undergoing various types of surgeries. It is not known whether this finding from studying heterogeneous patient groups is applicable to a particular surgical patient population. We performed . . . meta-analysis to determine whether anesthesia choice affected . . . outcome after elective total hip replacement."

Quoting the abstract of my previous study (2): "This study [meta-analysis] was designed to determine whether regional anesthesia decreases surgical time when compared to general anesthesia over a multitude of surgical procedures." From the Results: "Pooling . . . studies, regional anesthesia does not significantly decrease surgical time versus general anesthesia (mean difference was 1.7 min, 95% confidence interval –0.5 to 3.9 min) . . . Type of surgery may affect the results. There is a trend for regional anesthesia to decrease surgical time for studies of total hip replacement. Among the . . . studies . . . the pooled mean difference was 7.0 min (95% confidence interval 3.0–11.1 min)." Mauermann et al. calculated 7.1 min (95% confidence interval 2.3–11.9 min). The similarity is striking, even though Mauermann et al. were able to include more studies.

The overlap of results is evidence to the consistently impressive value in using meta-analysis to study differences in procedural durations among anesthetic techniques. However, I think that the similarity should have warranted reference of my prior work (2) and discussion of it in relation to the authors’ paper (1).

REFERENCES

1. Mauermann WJ, Shilling AM, Zuo Z. A comparison of neuraxial block versus general anesthesia for elective total hip replacement: a meta-analysis. Anesth Analg 2006;103:1018–25.[Abstract/Free Full Text]
2. Dexter F. Regional anesthesia does not significantly change surgical time versus general anesthesia—a meta-analysis of randomized studies. Reg Anesth Pain Med 1998;23:439–43.[Web of Science][Medline]

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