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 .
Antithrombotic efficacy of continuous extradural analgesia after knee replacement.
We have studied the effect of extradural analgesia on postoperative venous thrombosis in patients undergoing knee arthroplasty . Forty-eight patients were allocated r and omly to receive either general anaesthesia or extradural analgesia with local anaesthetics for 3 days . All patients wore compressive elastic stockings and no anticoagulant drugs were administered . Bilateral venography was performed 10 days after surgery . Continuous extradural analgesia did not impede mobilization of the patients . One case of nonfatal pulmonary embolism occurred in a patient who received general anaesthesia . The use of continuous extradural analgesia result ed in a significant difference in the total incidence of deep vein thrombosis ( 18 % compared with 59 % after general anaesthesia ( P = 0.02 ] . The incidence of calf vein thrombosis was 12 % compared with 45 % after general anaesthesia ( 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 .