Evidence-Based Anesthesia for Major Gynecologic Surgery

Publication date: Available online 31 December 2014 Source:Anesthesiology Clinics Author(s): Jeanette R. Bauchat , Ashraf S. HabibTeaser Studies on enhanced recovery after gynecological surgery are limited but seem to report outcome benefits similar to those reported after colorectal surgery. Regional anesthesia is recommended in enhanced recovery protocols. Effective regional anesthetic techniques in gynecologic surgery include spinal anesthesia, epidural analgesia, transversus abdominis plane blocks, local anesthetic wound infusions and intraperitoneal instillation catheters. Non-opioid analgesics including pregabalin, gabapentin, NSAIDs, COX-2 inhibitors, and paracetamol reduce opioid consumption after surgery. This population is at high risk for PONV, thus, a multimodal anti-emetic strategy must be employed, including strategies to reduce the baseline risk of PONV in conjunction with combination antiemetic therapy.
Source: Anesthesiology Clinics - Category: Anesthesiology Source Type: research