Epidural or spinal anaesthesia reduces major postoperative complications

December 14, 2000

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

Giving patients epidural or spinal anaesthesia (known as neuraxial blockade) during major surgery reduces mortality by about a third and also reduces the risk of serious postoperative complications in a wide range of patient groups, finds a study in this week's BMJ.

Rodgers and colleagues analysed 141 trials, involving over 9,500 patients, to provide more reliable estimates of the effects of neuraxial blockade. In patients receiving neuraxial blockade, overall mortality was reduced by about a third. Neuraxial blockade also approximately reduced the odds of deep vein thrombosis by 44%, pulmonary embolism by 55%, transfusion requirements by 50%, pneumonia by 39%, and respiratory depression by 59%. There were also reductions in heart attack and kidney failure. Furthermore, the benefits did not differ by the type of surgical group, the type of neuraxial blockade (epidural or spinal), or in trials where neuraxial blockade was combined with general anaesthesia, add the authors.

The size of some of these benefits remains uncertain, and further research is required to determine whether these effects are due solely to benefits of neuraxial blockade or partly to avoidance of general anaesthesia, say the authors. However, given that the risks of fatal or life threatening events are increased several fold after major surgery, these findings support more widespread use of neuraxial blockade, they conclude.

Anthony Rodgers, Clinical Trials Research Unit, Division of Medicine, The University of Auckland, New Zealand
Email: a.rodgers@ctru.aukland.ac.nz


Stephen Schug, Division of Anaesthesiology, The University of Auckland, New Zealand
Email: s.schug@auckland.ac.nz


Related Mortality Articles from Brightsurf:

Being in treatment with statins reduces COVID-19 mortality by 22% to 25%
A research by the Universitat Rovira i Virgili (URV) and Pere Virgili Institut (IISPV) led by LluĂ­s Masana has found that people who are being treated with statins have a 22% to 25% lower risk of dying from COVID-19.

Mortality rate higher for US rural residents
A recent study by Syracuse University sociology professor Shannon Monnat shows that mortality rates are higher for U.S. working-age residents who live in rural areas instead of metro areas, and the gap is getting wider.

COVID-19, excess all-cause mortality in US, 18 comparison countries
COVID-19 deaths and excess all-cause mortality in the U.S. are compared with 18 countries with diverse COVID-19 responses in this study.

New analysis shows hydroxychloroquine does not lower mortality in COVID-19 patients, and is associated with increased mortality when combined with the antibiotic azithromycin
A new meta-analysis of published studies into the drug hydroxychloroquine shows that it does not lower mortality in COVID-19 patients, and using it combined with the antibiotic azithromycin is associated with a 27% increased mortality.

Hydroxychloroquine reduces in-hospital COVID-19 mortality
An Italian observational study contributes to the ongoing debate regarding the use of hydroxychloroquine in the current pandemic.

What's the best way to estimate and track COVID-19 mortality?
When used correctly, the symptomatic case fatality ratio (sCFR) and the infection fatality ratio (IFR) are better measures by which to monitor COVID-19 epidemics than the commonly reported case fatality ratio (CFR), according to a new study published this week in PLOS Medicine by Anthony Hauser of the University of Bern, Switzerland, and colleagues.

COVID-19: Bacteriophage could decrease mortality
Bacteriophage can reduce bacterial growth in the lungs, limiting fluid build-up.

COPD and smoking associated with higher COVID-19 mortality
Current smokers and people with chronic obstructive pulmonary disease (COPD) have an increased risk of severe complications and higher mortality with COVID-19 infection, according to a new study published May 11, 2020 in the open-access journal PLOS ONE by Jaber Alqahtani of University College London, UK, and colleagues.

Highest mortality risks for poor and unemployed
Large dataset shows that income, work status and education have a clear influence on mortality in Germany.

Addressing causes of mortality in Zambia
Despite the fact that people in sub-Saharan Africa are now living longer than they did two decades ago, their average life expectancy remains below that of the rest of the world population.

Read More: Mortality News and Mortality Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.