Does regional anaesthesia improve outcome?

Publication date: Available online 22 September 2018

Source: Anaesthesia & Intensive Care Medicine

Author(s): Kathryn Hill, Alan JR. Macfarlane

Abstract

Outcome after surgery is of interest to the patient, the surgeon and the healthcare institution. There is conclusive evidence that regional anaesthesia is associated with superior analgesic outcomes compared to opioid-based analgesic techniques and may also reduce chronic pain. While better pain control and avoiding a general anaesthetic may alone be regarded as significant outcome benefits, regional anaesthesia and analgesia may influence many other important outcomes. Regional anaesthesia clearly reduces postoperative nausea and vomiting and pulmonary complications compared to general anaesthesia. Regional anaesthesia independently reduces length of stay and is a common component of enhanced recovery packages. Contemporary, but less robust, data suggests that neuraxial anaesthesia, and to a lesser extent analgesia, may reduce blood transfusion requirements, surgical site infection, intensive care admission, cancer recurrence and maybe even mortality. Any functional outcome benefits secondary to regional anaesthesia appear to be short lived and are generally not sustained long term.

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