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 analgesia after circumcision in children.
The analgesic effects of systemically administered diamorphine , caudal analgesia with 0.5 % bupivacaine plain and caudal analgesia with 0.5 % bupivacaine plain to which morphine sulphate had been added were studied in boys undergoing circumcision . Postoperative analgesia was assessed using a linear analogue scale . The time interval between operation and subsequent analgesic administration and the number of analgesic doses in 24 h were compared . The frequency of vomiting was noted . All three methods provided satisfactory results . The only detectable difference between the groups was a more rapid , but transient , recovery in the group receiving plain bupivacaine only . The frequency of vomiting was high in all groups . Caudal analgesia , with or without the addition of morphine , did not confer any advantage over injected diamorphine , and did not justify the extra time , risk and expense required to carry it out
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 .