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Major complications of central neuraxial block: the Third National Audit Project: some comments and questions
Kalmar, Stockholm and Lund, Sweden
* E-mail: vibekem@ltkalmar.se
| The first 150 words of the full text of this article appear below. |
Editor—The Third National Audit Project (NAP3) is the largest prospective study regarding the incidence of complications after central neuraxial blocks (CNBs) performed.1 All collaborators are to be congratulated with the success of this ambitious project. The numbers of patients and complications included are considerable, and highly reliable information was obtained.
Unfortunately, the impact of the results might be reduced by their presentation. Obstetric patients, well known to constitute a low-risk group, are included in the denominator, predictably reducing the incidence of complications. In accordance with the endpoints of the study (permanent damage or death), successfully treated complications are excluded from statistics presented in the abstract (and press release), also contributing to a lower incidence of complications. However, patient outcome is dependent on vigilance and suspicion of a complication, in turn largely based on the perceived probability of such a complication arising. The present study illustrates this relationship, as permanent damage
1 Bath, UK
2 Wrexham, UK
3 Dundee, UK
* E-mail: tcook@rcoa.ac.uk