Authors	Date assessed as up‐to‐date	Number of studies/Number of participants	Population	Interventions and comparison interventions	Major findings
Neuraxial blockade versus general anaesthesia
Afolabi 2006	14 August 2006	16 1586	Pregnant women Caesarean section for any indication	Epidural anaesthesia or Spinal anaesthesia versus General anaesthesia	Neuraxial blockade reduces: maternal decrease in hematocrit (MD 1.70, 95% CI 0.47 to 2.93); and maternal estimated blood loss: epidural (MD ‐127 mL, 95% CI ‐225 to ‐28.9) and spinal (‐84.8, 95% CI ‐127 to ‐42.6). General anaesthesia: was preferred by more women for subsequent procedures compared with epidural (OR 0.56, 95% CI 0.32 to 0.96) or spinal (OR 0.44, 95% CI 0.24 to 0.81); and decreased the incidence of nausea compared with epidural (OR 3.17, 95% CI 1.64 to 6.14).
Barbosa 2010	9 June 2008	Four 696	Adults Lower limb revascularization	Epidural anaesthesia or Spinal anaesthesia versus General anaesthesia	No difference: in mortality (OR 0.89, 95% CI 0.38 to 2.07); in myocardial infarction (OR 1.23, 95% CI 0.56 to 2.70); or in lower limb amputation (OR 0.84, 95% CI 0.38 to 1.84). Neuraxial blockade reduces: the incidence of pneumonia (OR 0.37, 95% CI 0.15 to 0.89).
Craven 2003	31 March 2003	Three 108	Preterm infants Inguinal herniorrhaphy	Spinal anaesthesia versus General anaesthesia	No difference in: postoperative oxygen desaturation (RR 0.91, 95% CI 0.61 to 1.37). Excluding infants who received preoperative sedatives, neuraxial blockade: reduces postoperative apnoea (RR 0.39, 95% CI 0.19 to 0.81).
Parker 2004	10 June 2004	22 2567	Adults Hip fracture	Epidural anaesthesia or Spinal anaesthesia versus General anaesthesia	Neuraxial blockade: reduces 30‐day mortality (RR 0.69, 95% CI 0.50 to 0.95).
Neuraxial blockade added to general anaesthesia
Choi 2003	13 May 2003	13 606	Adults Hip or knee replacement	Epidural analgesia versus Systemic analgesia	Neuraxial blockade: reduces pain at rest at four to six hours (SMD 0.77, 95% CI ‐1.24 to ‐0.31); reduces the frequency of sedation (OR 0.30, 95% CI 0.09 to 0.97); increases urinary retention (OR 3.50, 95% CI 1.63 to 7.51); increases itching (OR 4.74, 95% CI 1.76 to 12.78); and increases the frequency of low blood pressure (OR 2.78, 95% CI 1.15 to 6.72).
Cyna 2008	13 April 2008	10 721	Male children Circumcision	Caudal epidural block versus Systemic analgesia or Dorsal nerve penile block	Neuraxial blockade versus parenteral analgesia. No difference in the need for rescue analgesia or other analgesia (RR 0.41, 95% CI 0.12 to 1.41). No difference in the incidence of nausea and vomiting (RR 0.61, 95% CI 0.36 to 1.05). Neuraxial blockade versus dorsal nerve penile block. No difference in the need for rescue analgesia or other analgesia (RR 1.25, 95% CI 0.64 to 2.44). No difference in the incidence of nausea and vomiting (RR 1.88, 95% CI 0.70 to 5.4). Increases individual motor block (RR 17.0, 95% CI 1.01 to 286.8). Increases leg weakness (RR 10.7, 95% CI 1.32 to 86.1). Neuraxial blockade versus rectal or intravenous analgesia. No difference in the need for rescue analgesia or other analgesia.
Jorgensen 2000	31 August 2000	22 1023	Adults Abdominal surgery	Epidural local anaesthetic versus Systemic opioids or Epidural opioids	Substantial heterogeneity Neuraxial blockade with local anaesthetic versus systemic opioids: reduces time to return of gastrointestinal function (37 hours). Neuraxial blockade with local anaesthetic versus epidural opioid: reduces time to return of gastrointestinal function (24 hours).
Nishimori 2012	16 January 2011	13 1224	Adults Elective open abdominal aortic surgery	Epidural analgesia versus Systemic opioid–based pain relief	Neuraxial blockade (especially thoracic epidural): reduces the duration of tracheal intubation and mechanical ventilation by about 20%; reduces the overall incidence of cardiovascular complications; reduces the incidence of myocardial infarction; reduces the incidence of acute respiratory failure (defined as extended need for mechanical ventilation); reduces the incidence of gastrointestinal complications; reduces the incidence of renal insufficiency; reduces pain scores at movement for up to three days; and does not affect the mortality rate (OR 0.86, 95% CI 0.48 to 1.55).
Werawatganon 2005	13 October 2004	Nine 711	Adults Intra‐abdominal surgery	Epidural analgesia versus Patient‐controlled analgesia with intravenous opioids	Neuraxial blockade: reduces pain scores at six hours (MD for patient‐controlled analgesia with intravenous opioids 1.74, 95% CI 1.30 to 2.19); and increases the incidence of pruritus (OR for patient‐controlled analgesia with intravenous opioids 0.27, 95% CI 0.11 to 0.64).