The effect of neuraxial blocks on surgical blood loss and blood transfusion requirements: a meta-analysis.
OBJECTIVE
The aim of this study was to evaluate the effect of neuraxial blocks on surgical blood losses and on the number of patients requiring blood transfusion.


METHODS
A search of the American National Library of Medicine's PubMed up to November 12, 2004, was performed. Twenty-four studies could be kept for analysis.


RESULTS
Regional anesthesia reduced the number of transfused patients for total hip replacement (P = 0.0009) and spinal fusion (P = 0.04). A reduction of measured blood loss that did not lead to a reduction in the number of transfused patients was also found for fractured hip surgery (P < 0.0001), lumbar disk surgery (P = 0.01), peripheral vascular surgery (P = 0.03), retropubic prostatectomy (P = 0.02), cesarean section (P < 0.0001), and bowel surgery (P = 0.0008). In summary neuraxial blocks have a clear and definite effect on surgical blood loss, but this effect do not usually lead to a reduction in the number of transfused patients except for patients undergoing total hip replacement and spinal fusion.
Guay
Joanne
J
Department of Anesthesia, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada H1T 2M4. joanne.guay@umontreal.ca
D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D016063:Blood Loss, Surgical / Q000517:prevention & control / Q000706:statistics & numerical data*; D001803:Blood Transfusion; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D009407:Nerve Block; D013123:Spinal Fusion / Q000009:adverse effects