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 Apnea, Bradycardia, and Oxygen Desaturation in Formerly Premature Infants: Prospective Comparison of Spinal and General Anesthesia
Eighteen formerly premature infants scheduled for inguinal herniorrhaphy and who were less than 51 wk postconceptional age were assigned to either the general anesthesia group ( GA : atropine , halothane , and nitrous oxide ) or the spinal anesthesia group ( SA : hyperbaric tetracaine ) . Twelve-hour , three-channel continuous recordings of respiratory rate ( chest wall impedance ) , electrocardiogram ( ECG ) , and  hemoglobin O2 saturation ( Spo2 ) were obtained preoperatively and after surgery . These were analyzed for short ( 11 - 15 s ) and long ( > 15 s ) apnea spells , periodic breathing , and episodes of hemoglobin oxygen desaturation and bradycardia . Infants in the GA group had lower postoperative minimum Spo2 ( 68.7 % + /- 11.4 % ) and minimum heart rate ( 79 bpm + /- 19 ) than infants in the SA group ( 80.7 % + /- 9.2 % , and 109 bpm + /- 30 , respectively ; P < 0.05 ) and had lower postoperative minimum Spo2 and minimum heart rate than they had preoperatively ( 79.0 % + /- 13.7 % , and 93 bpm + /- 31 , respectively ; P < 0.05 ) ; pre- and postoperative studies in the SA group did not differ . There were no differences in the incidence of postoperative central apnea . We conclude that spinal anesthesia reduces postoperative hemoglobin oxygen desaturation and bradycardia in formerly premature infants undergoing inguinal herniorrhaphy . ( Anesth Analg 1995;80:7 - 13
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 .