Can Neuraxial Anesthesia Reduce Perioperative Mortality?

Clinical summary

Technique

Indications

Cautions

Notes

Neuraxial anesthesia

Lower extremity major joint procedures

–

Suggestive reduction in mortality

Neuraxial anesthesia/analgesia

Cardiac surgery

Neuraxial hematoma

No conclusive effect on mortality

Neuraxial anesthesia

Lower extremity vascular surgery

–

No conclusive effect on mortality

Neuraxial anesthesia

Elective endovascular aortic aneurysm repair

–

No conclusive effect on mortality

Neuraxial anesthesia

Cancer surgery

–

Suggestive reduction in mortality

References

Rodgers A, Walker N, Schug S et al (2000) Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ 321:1493PubMedCrossRef

Urwin SC, Parker MJ, Griffiths R (2000) General versus regional anesthesia for hip fracture surgery: a meta-analysis of randomized trials. BJA 84:450–455PubMedCrossRef

Parker MJ, Handoll HH, Griffiths R (2004) Anaesthesia for hip fracture surgery in adults. Cochrane Database Syst Rev 4:CD000521

Le-Wendling L, Bihorac A, Baslanti TO et al (2012) Regional anesthesia as compared with general anesthesia for surgery in geriatric patients with hip fracture: does it decrease morbidity, mortality and health care costs? Results of a single-centered study. Pain Med 13:948–956PubMedCrossRef

Neuman MD, Silber JH, Elkassabany NM et al (2012) Comparative effectiveness of regional versus general anesthesia for hip fracture surgery in adults. Anesthesiology 117:72–92PubMedCrossRef

Memtsoudis SG, Sun X, Chiu YL et al (2013) Perioperative comparative effectiveness of anesthetic technique in orthopedic patients. Anesthesiology 118:1046–1058PubMedCrossRef

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