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 Infusion of Bupivacaine 0.0625% plus Fentanyl 3.3 μg/ml Provides Better Postoperative Analgesia than Patient-Controlled Analgesia with Intravenous Morphine after Gynaecological Laparotomy
One hundred and twenty women undergoing gynaecological abdominal operations were r and omized to receive either epidural bupivacaine 0.0625%+fentanyl 3.3μg/ml infusion ( Group EPI , n=57 ) , or patient-controlled intravenous morphine analgesia ( Group PCA , n=54 ) for postoperative pain relief . The groups were comparable in demographic data , types and duration of operation . Group EPI achieved significantly lower verbal rating scale of pain ( VRS ) at rest at 0 , 4 , 12 , 16 , 20 , 28 and 40th postoperative hours . The VRS during cough were also significantly lower in Group EPI at 0 , 4 , 8 , 12 , 28 and 36th postoperative hours . None of the patients had respiratory depression or hypotension . Nausea/vomiting occurred in 52.6%/33.3 % of patients in Group EPI and 52.7%/37.0 % in Group PCA . Most patients ( 84.2 % in Group EPI and 72.2 % in Group PCA ) rated their pain management as “ good ” . We conclude that epidural infusion of bupivacaine 0.0625 % and fentanyl 3.3μg/ml provide better analgesia than patient-controlled intravenous morphine after gynaecological
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 .