Does regional anaesthesia improve outcome after surgery?

Publication date: Available online 26 September 2015 Source:Anaesthesia & Intensive Care Medicine Author(s): Barrie Fischer, Oscar Domingo Bosch There is conclusive evidence that regional anaesthesia provides better postoperative analgesia than systemic opioid techniques. Regional anaesthesia also has the potential to improve the functional outcome from surgery, although proving this in a clinically relevant way is challenging; many studies are inconclusive with methodological weaknesses making comparison difficult and offering conflicting evidence. Systematic reviews offer better evidence that regional anaesthesia improves outcome but both anaesthetic and surgical practice have evolved over time, so older data may not be relevant to current practice. Regional anaesthesia improves outcome only when incorporated into a structured postoperative rehabilitation and recovery programme (enhanced recovery), using the effective analgesia provided to achieve specific targets. These targets include early mobilization, active physiotherapy and early return to enteral nutrition. Other benefits of regional anaesthesia (reduced blood loss, lower risk of thromboembolic events and duration of ileus) also contribute to a reduction in postoperative morbidity. However, unless the postoperative recovery programme is modified to incorporate these benefits into a patient's recovery, the full impact of regional anaesthesia on surgical outcome will not be realized.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research

Related Links:

etzke F Abstract Chronic pain is a frequent comorbidity of patients in hospitals and has an influence on the clinical course and the duration of hospitalization. There is a need to have a better understanding of chronic pain as a comorbidity and it should be considered to a greater extent in understanding diseases, in treatment concepts and hospital structures to ensure a resource-oriented and high-quality care. This begins on admission by identifying pre-existing pain and related risk factors with the medical history and taking these into account in the treatment regimen. A multimodal tre...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research
Conclusion: This study provided evidence that ACB as postoperative analgesia after TKR is associated with better outcomes in terms of facilitating early functional recovery and mobility, and consequently prevents major postoperative complications.
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
ConclusionThe location of the sublingual gland in the floor of the mouth coupled with the physio-pathogenesis of the plunging ranula, makes the transoral complete excision of the offending gland, with the intraoral evacuation of the pseudocyst, anatomically the most rational approach for plunging ranula management. There is no need for cervical approach, ranula dissection and/or postoperative placement of drainage.
Source: American Journal of Otolaryngology - Category: Endocrinology Source Type: research
A 63-YEAR-OLD male (weight 51 kg, height 155 cm) underwent mitral valve repair for mitral regurgitation using a 28 mm Carpentier-Edwards Physio annuloplasty ring (Edwards Lifesciences, Irvine, CA). Bicaval cannulation was performed, and a transseptal approach was adopted. A left atrial vent (16 French) was inserted through the right pulmonary vein. A repeat transesophageal echocardiography (TEE) examination was performed before separation from cardiopulmonary bypass. At this juncture, a 4-chamber midesophageal TEE interrogation identified a “paravalvular” leak at what would be the normal location of the P1 scal...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research
Authors: Schönhofer B, Geiseler J, Dellweg D, Fuchs H, Moerer O, Weber-Carstens S, Westhoff M, Windisch W, Hirschfeld-Araujo J, Janssens U, Rollnik J, Rosseau S, Schreiter D, Sitter H, Weitere beteiligte wissenschaftliche Fachgesellschaften und Institutionen: Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin e. V. (DGAI), Deutsche Gesellschaft für Chirurgie e. V. (DGCH), Deutsche Gesellschaft für Ernährungsmedizin e. V. (DGEM), Deutsche Gesellschaft für Geriatrie e. V. (DGG), Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin e. V. (DGII...
Source: Pneumologie - Category: Respiratory Medicine Tags: Pneumologie Source Type: research
CONCLUSION: In contrast to commonly used perioperative risk classifications, frailty is a sensitive marker for the patient's biological age. Therefore, it appears more suitable for estimating the perioperative risk than chronological age or other conventional tools, such as the ASA classification and is therefore a prerequisite for patient centered treatment pathways. PMID: 31802172 [PubMed - as supplied by publisher]
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research
Abstract Trauma affecting the chest wall, even in isolation, can carry a significant morbidity and mortality and thus appropriate management is vital. Consequences of chest wall trauma may include significant pain, altered chest wall mechanics, hypoventilation, infection and respiratory failure. In order to best determine the appropriate management, risk stratification tools have been developed to identify patients at highest risk of complications who would most benefit from more invasive management strategies. Early optimization of analgesia is vital both for patient experience and to reduce the risk of pulmonary...
Source: British Journal of Hospital Medicine - Category: Internal Medicine Authors: Tags: Br J Hosp Med (Lond) Source Type: research
te;l J, Iványi Z Abstract Introduction: Infections affect about 30-50% of intensive care unit patients resulting in substantial morbidity and mortality. Multimodal interventions proved to be successful in the prevention of healthcare-associated infections. Appropriate hand hygiene including correct disinfection technique and timing is essential. Aim: The aim of our study was to investigate the hand hygiene practice among the intensive care unit healthcare workers by immediate feedback system implementation and compliance study. Method: A 3-week-long observational study was conducted at the Department of Ana...
Source: Orvosi Hetilap - Category: General Medicine Authors: Tags: Orv Hetil Source Type: research
Nonintubated thoracic surgery arose as supplemental evolution of minimally invasive surgery and is gaining popularity. A proper nonintubated thoracic surgery unit is mandatory and should involve surgeons, anesthesiologists, intensive care physicians, physiotherapists, psychologists, and scrub and ward nurses. Surgical training should involve experienced and young surgeons. It deserves a step-by-step approach and consolidated experience on video-assisted thoracic surgery. Due to difficulty in reproducing lung and diaphragm movements, training with simulation systems may be of scant value; instead, preceptorships and invited...
Source: Thoracic Surgery Clinics - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
Introduction: Early mobilization often in combination with breathing exercises is highly recommended after abdominal surgery. However, the isolated effect of early mobilization on respiratory function is still not evaluated. The overall aim was to evaluate the effects of immediate mobilization, within 2h (hours) after surgery on respiratory function in patients undergoing elective abdominal surgery.Material and methods: A total of 201 adult patients who underwent elective abdominal surgery, where the anesthetic time exceeded 2h, were randomized to: Mobilization - to sit in a chair + breathing exercises with PEP (n=68)Mobil...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Physiotherapists Source Type: research
More News: Anesthesia | Anesthesiology | Intensive Care | Nutrition | Physiotherapy | Rehabilitation | Study