Techniques in Regional Anesthesia & Pain Management
Volume 12, Issue 4 , Pages 183-193, October 2008

The role of regional anaesthesia in patient outcome: thoracic and abdominal surgeries

  • Avinash Sinha, MBChB, FRCA

      Affiliations

    • Corresponding Author InformationAddress reprint requests and correspondence: Avinash Sinha, MBChB, FRCA, Acute Pain Management Service, Montréal General Hospital, McGill University Health Centre, 1650 Cedar Avenue, Montréal, H3G 1B7, Quebec, Canada
  • ,
  • Franco Carli, MD, MPhil, FRCA, FRCPC

Department of Anaesthesia, Montréal General Hospital, McGill University Health Centre, Montréal, Quebec, Canada

This review focuses on the establishment and implementation of well-defined, evidence-based clinical pathways in thoracic and abdominal surgeries, to facilitate improved outcomes and avoid complications, enabling rapid recognition and treatment of complications. Ultimately, this will facilitate the recovery process and return to baseline activity. Patients scheduled for either thoracic or abdominal surgery often have compromised cardiopulmonary and metabolic functions before surgery, and the procedure itself may decrease patients' reserve. Postoperative pain acts as an additional insult to body reserve, and regional anesthesia can be the most efficient technique to attenuate this. The greatest postoperative challenge for anesthetists is to attenuate the stress response and pain sufficiently so that functions are not compromised even further. Even the best postoperative regional analgesic techniques require a smooth and timely transition to oral multimodal pain strategies to maximize their benefits.

Keywords: Thoracic surgery, Abdominal surgery, Thoracic epidural analgesia, Paravertebral blockade

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PII: S1084-208X(08)00044-X

doi:10.1053/j.trap.2008.09.003

Techniques in Regional Anesthesia & Pain Management
Volume 12, Issue 4 , Pages 183-193, October 2008