Reduction of postoperative mortality and morbidity

doi:10.1136/bmj.322.7295.1182

BMJ 2001;322:1182 ( 12 May )

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Reduction of postoperative mortality and morbidity

Little information was given on inclusion criteria

Research into modern anaesthesia techniques and perioperative medicine is needed

Authors' reply

Little information was given on inclusion criteria

The first 150 words of the full text of this article appear below.

EDITOR $---$ Rodgers et al report a meta-analysis of 141 trials comparing general anaesthesia with neuraxial blocks.¹ They concludethat their data should result in more widespread use of spinalor epidural anaesthesia. The challenge for clinicians is decidingwhich of their patients (if any) these results apply to, but Rodgerset al provided little information about the inclusion criteriafor the trials examined. The applicability of a meta-analysisis difficult to assess when heterogeneous patient groups are combined.Also, although a spinal or epidural anaesthetic might be reasonablystandard, there are many general anaesthetic agents and thesemay not becomparable.

Figure 1 of the meta-analysis shows that four trials contributed 31 deaths to the overall mortality difference of 41.^2-5In those four studies the mortality from general anaesthesia rangedfrom 8% to 27%, compared with 3.1% for all trialscombined.

We wonder whether any information was collated on antithrombosis prophylaxis. In . . . [Full text of this article]

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