Influence of anaesthetic and analgesic techniques on outcome after surgery.
Postoperative symptoms and complications can be prevented by a suitable choice of anaesthetic and analgesic technique for specific procedures. The aim of analgesic protocols is not only to reduce pain intensity but also to decrease the incidence of side-effects from analgesic agents and to improve patient comfort. Moreover, adequate pain control is a prerequisite for the use of rehabilitation programmes to accelerate recovery from surgery. Thus, combining opioid and/or non-opioid analgesics with regional analgesic techniques not only improves analgesic efficacy but also reduces opioid demand and side-effects such as nausea and vomiting, sedation, and prolongation of postoperative ileus. Although all attempts to demonstrate that regional anaesthesia and analgesia decrease postoperative mortality are unsuccessful, there is evidence supporting a reduction in pulmonary complications after major abdominal surgery, and an improvement in patient rehabilitation after orthopaedic surgery. When such techniques are used, cost-benefit analysis should be considered to determine suitable analgesic protocols for specific surgical procedures.
Bonnet
F
F
Service d'Anesthésie-Réanimation, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, France. francis.bonnet@tnn.ap-hop-paris.fr
Marret
E
E
D000005:Abdomen / Q000601:surgery; D000698:Analgesia / Q000009:adverse effects / Q000379:methods*; D000700:Analgesics / Q000009:adverse effects; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D000765:Anesthesia, Conduction / Q000379:methods; D000767:Anesthesia, Epidural / Q000379:methods; D001012:Aorta, Abdominal / Q000601:surgery; D006801:Humans; D009292:Narcotic Antagonists / Q000009:adverse effects; D019637:Orthopedic Procedures; D010149:Postoperative Pain / Q000517:prevention & control; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control*
D000700:Analgesics; D009292:Narcotic Antagonists