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 .
[Postoperative delirium after general anesthesia vs. spinal anesthesia in geriatric patients].
BACKGROUND Influence of the type of anesthesia on postoperative delirium was examined in geriatric patients with femoral neck fracture . METHODS Forty patients aged 70 or more were r and omly allocated to receive either general anesthesia ( sevoflurane , nitrous oxide in oxygen , G group , n = 21 ) or spinal anesthesia ( 0.5 % bupivacaine , S group , n = 19 ) . G group received the oxygen therapy during the 12-hour postoperative period . Postoperative assessment s included the rate of postoperative delirium during the 4-day postoperative period , oxygen saturation during the 18-hour postoperative period , the value of hemoglobin at 1 postoperative day and the number of analgesics requirements during the 4-day postoperative period . RESULTS The rate of postoperative delirium was similar between the two groups during the 4-day postoperative period . However , that of S group tended to be higher during the 1-day postoperative period . Postoperative analgesic effect and the value of hemoglobin at 1 postoperative day were similar between the two groups . Oxygen saturation was similar between the two groups except 6 hours after the operation . CONCLUSIONS The type of anesthesia , general or spinal , does not affect the postoperative delirium in geriatric patients with femoral neck fracture
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 .