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 .
Epidemiology and morbidity of regional anesthesia in children: a follow-up one-year prospective survey of the French-Language Society of Paediatric Anaesthesiologists (ADARPEF).
BACKGROUND The French- Language Society of Paediatric Anaesthesiologists ( ADARPEF ) design ed a 1-year prospect i ve , multicenter and anonymous study to up date both epidemiology and morbidity of  regional anesthesia in children . METHODS From November 2005 to October 2006 , data from participating hospitals were recorded using an identification form , a data recording form , and a complication form . Information collected included the characteristics of the hospitals , the number and type of regional anesthetics ( RA ) , the age of the involved children as well as the incidence , and type of complications . RESULTS Data collected in 47 institutions included 104,612 pure general anesthesias ( GAs ) , 29,870 GAs associated with regional blocks , and 1262 pure regional blocks .  Central blocks accounted for 34 % of all RA . Peripheral blocks ( 66 % ) were upper or lower limb blocks ( 29 % of peripheral blocks ) , trunk blocks , and face blocks ( 71 % ) . In children aged ≤3 years , the percentage of central blocks was similar to the peripheral ones ( 45 % vs 55 ) , while in older children , peripheral blocks were more than four times used than central ones . Complications ( 41 involving 40 patients ) were rare and usually minor . They did not result in any sequelae . The study revealed an overall rate of complication of 0.12 % ; CI 95 % [ 0.09 - 0.17 ] , significantly six times higher for central than for peripheral blocks . CONCLUSIONS As a result of the low rate of complications , RA techniques have a good safety profile and can be used to provide postoperative analgesia . In addition , the results should encourage anesthesiologists to continue to use peripheral instead of central ( including caudal ) blocks as often as possible when appropriate
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 .