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 .
Major Complications of Regional Anesthesia in France: The SOS Regional Anesthesia Hotline Service
Background Several previous surveys have estimated the rate of major complications that occur after regional anesthesia . However , because of the increase in the use of regional anesthesia in recent years and because of the introduction of new techniques , re appraisal of the incidence and the characteristics of major complications is useful . Methods All French anesthesiologists were invited to participate in this 10-month prospect i ve survey based on ( 1 ) voluntary reporting of major complications related to regional anesthesia occurring during the study period using a telephone hotline service available 24 h a day and managed by three experts , and ( 2 ) voluntary reporting of the number and type of regional anesthesia procedures performed using pocket booklets . The service was free of charge for participants . Results The participants ( n = 487 ) reported 56 major complications in 158,083 regional anesthesia procedures performed ( 3.5/10,000 ) . Four deaths were reported . Cardiac arrest occurred after spinal anesthesia ( n = 10 ; 2.7/10,000 ) and posterior lumbar plexus block ( n = 1 ; 80/10,000 ) . Systemic local anesthetic toxicity consisted of seizures only , without cardiac toxicity .  Lidocaine spinal anesthesia was associated with more neurologic complications than bupivacaine spinal anesthesia ( 14.4/10,000 vs. 2.2/10,000 ) . Most neurologic complications were transient . Among 12 that occurred after peripheral nerve blocks , 9 occurred in patients in whom a nerve stimulator had been used . Conclusion This prospect i ve survey based on a free hotline permanent telephone service allowed us to estimate the incidence of major complications related to regional anesthesia and to provide a detailed analysis of these complications
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 .