title: Can anaesthetic technique effect postoperative outcome?
abstract: OBJECTIVE
  Conventional wisdom maintains that multiple aspects of surgical technique and management may affect postoperative outcome, while anaesthetic technique has little long-term effect on patient outcomes. There is accumulating evidence that, on the contrary, anaesthetic management may in fact exert a number of longer-term effects in postoperative outcome. Here, we review the most topical aspects of anaesthetic management which may potentially influence later postoperative outcomes.
  
  
  RESULTS
  There is strong evidence that administration of supplemental oxygen and the avoidance of perioperative hypothermia, allogeneic blood transfusion, hyperglycaemia or large swings in blood glucose levels reduces postoperative infection rates. There is also some evidence that the use of regional anaesthesia techniques reduces chronic postsurgical pain and that avoidance of nitrous oxide reduces the long-term risk of myocardial infarction. Current evidence is equivocal regarding the effects of anaesthesia techniques and cancer recurrence. The instigation of perioperative beta-blockade in noncardiac surgery may not reduce perioperative adverse events or improve postoperative cardiovascular risk.
  
  
  CONCLUSIONS
  Further prospective, large-scale human trials with long-term follow-up are required to clarify the association between anaesthesia and cancer recurrence, neurotoxicity and the developing brain and long-term postoperative cognitive dysfunction in the elderly.
authors.affiliation: Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland.
authors.forename: Trevor
authors.initials: T
authors.lastname: Kavanagh
authors.forename: Donal J
authors.initials: DJ
authors.lastname: Buggy
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D000818:Animals; D001803:Blood Transfusion; D003072:Cognition Disorders / Q000209:etiology; D006801:Humans; D009369:Neoplasms / Q000601:surgery; D009609:Nitrous Oxide / Q000494:pharmacology; D011183:Postoperative Complications / Q000209:etiology; D013530:Surgical Wound Infection; D014945:Wound Healing
chemical_list: D000319:Adrenergic beta-Antagonists; D009609:Nitrous Oxide