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LETTER TO THE EDITOR

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

Mayo Clinic College of Medicine; Rochester, MN (Mauermann) Department of Anesthesia (Shilling) Department of Anesthesiology; University of Virginia; Charlottesville, VA; Zz3c{at}virginia.edu (Zuo)

In Response:

We appreciate Dr. Dexter’s interest in our work. Dr. Dexter refers to his meta-analysis of operative times for a variety of surgical procedures performed under either regional or general anesthesia. Although Dr. Dexter’s analysis failed to show a significant difference in operative times between the two groups, a subset analysis of patients undergoing total hip replacement did show a 7.0-min reduction in surgical times for patients having surgery under regional anesthesia (spinal or epidural) (1).

Admittedly, we were unaware of this previous study by Dr. Dexter. His study was not identified in our literature search using the strategies described in our manuscript (2). We regret not referencing Dr. Dexter’s study in our paper.

It is interesting to note that, despite having included more eligible studies and the efforts of avoiding repeated use of the data from the same patients in our analysis, our results are markedly similar to Dr. Dexter’s (average 7.1 min reduction/ case in our study versus average 7.0 min reduction/case in Dr. Dexter’s study). This decreased surgical time by regional anesthesia was statistically significant in our study. However, as we mentioned in our paper, a difference of 7.1 min/case may have little clinical significance.

REFERENCES

1. 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]
2. 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]

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