Neuraxial blockade reduces major postoperative complications

The effect of neuraxial blockade with epidural or spinal anaesthesia on postoperative mortality and morbidity is uncertain. Although many clinical trials have investigated postoperative outcome with different types of anaesthesia, almost all have been too small to detect effects of plausible size. Rodgers et al (p 1493) report a systematic review of 141 randomised trials of intraoperative neuraxial blockade or not. Overall mortality was reduced by about a third in patients allocated neuraxial blockade, with no clear difference according to surgical group or type of blockade. Furthermore, postoperative complications such as deep vein thrombosis, pulmonary embolism, transfusion requirements, pneumonia, and respiratory depression were significantly reduced with neuraxial blockade.

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Relevant Article

Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials

Anthony Rodgers, Natalie Walker, S Schug, A McKee, H Kehlet, A van Zundert, D Sage, M Futter, G Saville, T Clark, and S MacMahon
BMJ 2000 321: 1493. [Abstract] [Full Text] [PDF]