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 .
Combined Epidural and General Anaesthesia versus General Anaesthesia for Abdominal Aortic Surgery: A Prospective Randomised Trial
Fifty patients undergoing elective abdominal aortic surgery were r and omised to receive either combined epidural and general anaesthesia and postoperative epidural analgesia ( CEGA ) or general anaesthesia and postoperative intravenous morphine infusion ( GA ) . Prospect i ve data was collected in order to compare the two groups . This included intraoperative cardiovascular changes and postoperative complications . The use of intraoperative vasopressors was significantly higher in the CEGA group ( P < 0.01 ) but the use of intravenous glyceryl trinitrate was significantly lower ( P < 0.01 ) . There was no significant difference between groups in regard to blood loss , volume replacement or in the number of patients requiring postoperative ventilation . Two patients in the CEGA group died postoperatively compared to one in the GA group ( not significant ) . There was no significant difference between groups in the total number or type of postoperative complications . Combining epidural anaesthesia with general anaesthesia altered intraoperative cardiovascular management but did not affect postoperative outcome
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 .