title: [Do anesthetic techniques influence postoperative outcomes? Part II].
abstract: The knowledge of the influence of anesthetic techniques in postoperative outcomes has opened a large field of research in recent years. In this second part, we review some of the major controversies arising from the literature on the impact of anesthetic techniques on postoperative outcomes in 6 areas: postoperative cognitive dysfunction, chronic postoperative pain, cancer recurrence, postoperative nausea/vomiting, surgical outcomes, and resources utilization. The development of protective and preventive anesthetic strategies against short and long-term postoperative complications will probably occupy an important role in our daily anesthetic practice. Dynamic postoperative pain control has been confirmed as one of the basic requirements of accelerated postoperative recovery programs ("fast-track surgery"), and it is also a preventive factor for development of chronic postoperative pain. The weight of anesthetic technique on postoperative immunosuppression is to be defined. The potential influence of anesthesia on cancer recurrence, is a highly controversial area of research. The classic pattern of perioperative fluid therapy may increase postoperative complications. On the other hand, the maintenance of normoglycemia and normothermia was associated with a decreased postoperative morbidity. The high volume of surgical procedures means that the adequacy of human, organizational and technological resources have a major impact on overall costs.
authors.affiliation: Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, España. neus.esteve@ssib.es
authors.forename: N
authors.initials: N
authors.lastname: Esteve
authors.forename: J
authors.initials: J
authors.lastname: Valdivia
authors.forename: A
authors.initials: A
authors.lastname: Ferrer
authors.forename: C
authors.initials: C
authors.lastname: Mora
authors.forename: H
authors.initials: H
authors.lastname: Ribera
authors.forename: P
authors.initials: P
authors.lastname: Garrido
mesh_terms: D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D002492:Central Nervous System Depressants / Q000009:adverse effects; D059350:Chronic Pain / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology; D003693:Delirium / Q000453:epidemiology / Q000209:etiology; D017707:Erythrocyte Transfusion; D005440:Fluid Therapy / Q000009:adverse effects; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D006930:Hyperalgesia / Q000517:prevention & control; D006943:Hyperglycemia / Q000517:prevention & control; D007035:Hypothermia / Q000517:prevention & control; D007902:Length of Stay; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000276:immunology / Q000601:surgery; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D011182:Postoperative Care / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000209:etiology; D013514:Surgical Procedures, Operative; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D002492:Central Nervous System Depressants