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 .
Thoracic epidural infusion for postoperative pain relief following abdominal aortic surgery: bupivacaine, fentanyl or a mixture of both?
Thirty patients who had undergone elective abdominal aortic surgery were studied in a prospect i ve , r and omised double‐blind comparison of thoracic epidural 0.2 % bupivacaine alone , thoracic epidural fentanyl alone and thoracic epidural 0.2 % bupivacaine combined with fentanyl .  Pain relief , pulmonary function , cardiovascular stability and side effects were assessed . Pain relief was excellent in the combined bupivacaine‐fentanyl series , being significantly better than the other groups ( p < 0.05 ) during the entire study period and was not accompanied by hypotension . Forced expiratory parameters were reduced in all groups throughout the study to 50–60 % of the pre‐operative values , but there were no significant differences between groups . The incidence of side effects attributable to either epidural bupivacaine or fentanyl was low . This study supports the increasing use of epidural infusion analgesia for postoperative pain management after abdominal surgery
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 .