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This Week In The Bmj

Neuraxial blockade reduces major postoperative complications

BMJ 2000; 321 doi: (Published 16 December 2000) Cite this as: BMJ 2000;321:b

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 (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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