Effects of general and epidural anesthesia on the formation of deep vein thrombosis after total knee arthroplasty: a meta-analysis

doi:10.3969/j.issn.2095-4344.2015.35.029

Abstract

Abstract:

BACKGROUND: Although the therapeutic effect of total knee arthroplasty for severe gonarthritis is reliable, deep vein thrombosis also occurred in many patients. Therefore, deep vein thrombosis has been a major reason for unexpected death after total knee arthroplasty.
OBJECTIVE: To study the incidence of deep vein thrombosis after total knee arthroplasty with general and epidural anesthesia.
METHODS: We searched “PubMed”, “Medline”, “Elsevier”, “Embase”, Cochrane library, “Wanfang”, “China National Knowledge Infrastructure” for papers published from January 2000 to March 2015. The mesh words were “total knee arthroplasty”, “TKA”, “thrombosis”, “DVT”, “randomized controlled trial”, “RCT” for studies concerning deep vein thrombosis after total knee arthroplasty with different anesthetic methods. The double blind method was used for data extraction and assessment of literature quality. Revman5.3 software was utilized to analyze the extracted data using meta-analysis.
RESULTS AND CONCLUSION: There were 8 studies including 885 patients. The heterogeneity of the included studies was very low (I²=0, P=0.72). The combined OR was 0.25 (95% confidence interval: 0.18, 1.35), indicating that continuous epidural anesthesia in total knee arthroplasty could apparently reduce the possible formation of postoperative deep vein thrombosis. Because of lack of the changes in coagulation factors under general anesthesia and epidural anesthesia, the mechanism underlying epidural anesthesia to reduce the incidence of deep vein thrombosis deserves further investigations. Among patients with deep vein thrombosis, continuous epidural anesthesia could diminish the possible formation of deep vein thrombosis. Thus, epidural anesthesia should be used firstly for knee replacement in patients with high risk of deep vein thrombosis.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Arthroplasty, Replacement, Knee, Venous Thrombosis, Anesthesia, Anesthesia, Epidural

CLC Number:

R318

Aikeremujiang•Muheremu, Huang Zhu-yi, Feng Lei, Ma Xian-zhi, Liu Qing. Effects of general and epidural anesthesia on the formation of deep vein thrombosis after total knee arthroplasty: a meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(35): 5735-5740.

Figures/Tables 5

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