Compared with general anaesthesia , a central neuraxial block may reduce the zero to 30-day mortality for patients undergoing surgery with intermediate to high cardiac risk ( level of evidence , moderate ) .
BACKGROUND Various beneficial effects derived from neuraxial blocks have been reported .
However , it is unclear whether these effects have an influence on perioperative mortality and major pulmonary/cardiovascular complications .
OBJECTIVES Our primary objective was to summarize Cochrane systematic review s that assess the effects of neuraxial blockade on perioperative rates of death , chest infection and myocardial infa rct ion by integrating the evidence from all such review s that have compared neuraxial blockade with or without general anaesthesia versus general anaesthesia alone for different types of surgery in various population s. Our secondary objective was to summarize the evidence on adverse effects ( an adverse event for which a causal relation between the intervention and the event is at least a reasonable possibility ) of neuraxial blockade .
Is penile block better than caudal epidural block for postcircumcision analgesia?
Purpose To compare caudal and penile block for post-operative analgesia in children undergoing circumcision with respect to efficacy , complication rates , and parental satisfaction . Methods The study population consisted of 100 ASA 1 and 2 boys aged 3 to 8 years who were undergoing circumcision for religious reasons . In all participants , inhalation anesthesia was administered with oxygen : nitrous oxide ( 1 : 2 ) and halothane . The participants were allocated r and omly into two groups of 50 children each . Group 1 received penile block and Group 2 caudal block . The penile block was achieved by injecting bupivacaine into the two compartments of the subpubic space , with an additional ventral infiltration of a small volume of bupivacaine along the raphe of the penis . For caudal block , 1 ml·kg−1 body weight of 0.25 % bupivacaine was administered . Results Penile block shortened the induction-incision time and enabled earlier discharge home compared with caudal block . One patient undergoing penile block and nine patients undergoing caudal block vomited . Conclusions Penile and caudal block are equally effective for postcircumcision analgesia and neither is associated with serious complications . Anesthesiologist preference should be the deciding factor in choosing one technique over the other
Compared with general anaesthesia , a central neuraxial block may reduce the zero to 30-day mortality for patients undergoing surgery with intermediate to high cardiac risk ( level of evidence , moderate ) .
BACKGROUND Various beneficial effects derived from neuraxial blocks have been reported .
However , it is unclear whether these effects have an influence on perioperative mortality and major pulmonary/cardiovascular complications .
OBJECTIVES Our primary objective was to summarize Cochrane systematic review s that assess the effects of neuraxial blockade on perioperative rates of death , chest infection and myocardial infa rct ion by integrating the evidence from all such review s that have compared neuraxial blockade with or without general anaesthesia versus general anaesthesia alone for different types of surgery in various population s. Our secondary objective was to summarize the evidence on adverse effects ( an adverse event for which a causal relation between the intervention and the event is at least a reasonable possibility ) of neuraxial blockade .