A new metaanalysis comparing general and spinal/ epidural types of anaesthesia has found that surgery using epidurals is less likely to produce adverse effects, regardless of what the surgery is for.

The analysis included 9559 patients from 141 randomised trials involving many types of surgery and 60 studies where patients received both general and epidural anaesthesia. Once evaluated, the data showed that the epidural/spinal regional an aesthesia (also know as neuraxial blockade) significantly reduced the odds of several common anaesthetic complications.

For example, neuraxial blockade reduced the odds for deep vein thrombosis by 44 per cent, pulmonary embolism by 55 per cent, pneumonia by 39 per cent, and respiratory depression by 59 per cent. Mortality was also reduced by one third in the local anaesthesia group compared with those receiving general anaesthesia alone.

This is all good news, but the study only looked at complications soon after surgery. Because of this, the authors do not comment on the rate of spinal problems after epidurals a common adverse effect of this type of anaesthesia (BMJ, 2000; 321: 1493-7).

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Written by What Doctors Don't Tell You

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