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 .
Epidural tramadol for postoperative pain relief
The efficacy of epidurally administered tramadol hydrochloride , a weak central ly acting analgesic , was studied for the relief of postoperative pain . Sixty patients undergoing abdominal surgery were r and omly allocated to three treatment groups to be given the following agents by the epidural route : group 1 tramadol 50 mg ; group 2 tramadol 100 mg ; group 3 10 ml of bupivacaine 0.25 % . The drugs were administered at the patients ' request with each patient being allowed four doses in the first 24 h following surgery . Blood pressure , pulse rate , respiratory rate , arterial blood gas analyses , pain scores , the interval between doses and the occurrence of any side effects were recorded . Pain scores ( assessed using a visual analogue scale ) were significantly less ( p < 0.05 ) at 3 , 12 , and 24 h in patients receiving tramadol 100 mg than in those receiving tramadol 50 mg or bupivacaine . The mean interval between doses for groups 1 , 2 and 3 was 7.40 h , 9.36 h and 5.98 h respectively . The mean interval in group 2 was significantly longer than in group 3 ( p < 0.05 ) . The incidence of nausea and vomiting in group 2 was significantly higher than in group 3 ( p < 0.05 )
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 .