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 .
[Changes in dementia rating scale scores of elderly patients with femoral neck fracture during perioperative period].
We evaluated changes in dementia rating scale scores in the revised version of Hasegawa 's dementia scale ( HDS-R ) , and rated dementia , 2 days before and 7 days after surgery in the elderly patients with femoral neck fracture . The 50 patients examined ranged in age from 70 years to 101 years . A perfect score in the HDS-R is 30 points , and a score below 20 points strongly suggests dementia . The results were as follows . In septuagenarian and octogenarian patients , the scale score was higher after surgery than the value before the surgery . Although the preoperative and postoperative scores of the patients who had been under epidural anesthesia were not significantly different , the score of patients who had been under general anesthesia was higher in the postoperative period than in the preoperative period . In octogenarian patients , there was a negative correlation between " postoperative score minus preoperative score " and " the number of the days from suffering fracture to surgery " . These results showed that general anesthesia is more advantageous than epidural anesthesia from the viewpoint of the intellectual faculty in septuagenarian and octogenarian patients with femoral neck fracture , and it is within the bounds of possibility that the intellectual faculty may decline if an octogenarian patient is operated after a long delay from the occurrence of fracture . To prevent this decline , patients must be operated on as soon as possible
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 .