For many surgical procedures, there are multiple options for delivery of anesthesia. Examples include general, regional, spinal, epidural, caudal, hypotensive, total or regional intravenous, inhalation, and nerve blocks. The route of delivery is important for efficiency and safety, but the effect of specific techniques on perioperative outcomes is controversial. In addition, some anesthetic methods are associated more than others with reductions in postoperative pain intensity, delirium, outpatient setting, length of hospital stay, or costs.1-8
Regional anesthesia techniques include central neuraxial blocks (spinal, epidural, or caudal anesthesia). For some surgical procedures, regional anesthesia has important advantages over general anesthesia. Besides providing excellent pain control during surgery, regional techniques are associated with fewer side effects, less blood loss, better cardiac and pulmonary function, and shortened stay in the post-anesthesia care unit.1-6
Total intravenous anesthesia (TIVA) has been applied in some surgeries, and has been compared to other anesthesia techniques. For example, during arthroscopic knee surgery, TIVA with propofol can help prevent increases in malonyldialdehyde (MDA) and ischemia-modified albumin (IMA) that are associated with ischemia-reperfusion caused by the tourniquet.5
Regional intravenous anesthesia (RIVA) is generally preferred over general for upper extremity surgery. Advantages include a blood-free surgery site, rapid onset and termination of the anesthetic effect, lack of necessity for severe sedation, and easy application.7
Nerve blocks are used for postoperative analgesia. Interscalene brachial plexus blockade (ISB) can provide both anesthesia and analgesia for shoulder surgery.8-10
All anesthesia techniques, local or general, are applied in specific surgical procedures, but published clinical studies are limited regarding the optimal technique for each surgery.
I invite authors to submit their original research and review articles regarding comparisons and interactions of anesthetic techniques and methods, in humans, or in animal models.
Guest Editor’s Profile
Dr. Ahmet Eroglu is a Professor of Anesthesiology and Reanimation at the Medical Faculty of Karadeniz Technical University in Trabzon, Turkey. His specializes in Critical Care Medicine, and he is a Consultant of Critical Care Medicine and Orthopedic Anesthesia. Dr. Eroglu graduated in Medicine at Istanbul University in 1986. At Karadeniz Technical University, he specialized in Anesthesiology (1999) and Critical Care Medicine (2011). Dr. Eroglu has numerous publications in peer-reviewed journals. His research has focused on general and local anesthetics; regional and hypotensive epidural anesthesia; orthopedic anesthesia and analgesia; acute pain control; postoperative and patient-controlled analgesia; hazards of anesthetic gases; clinical toxicology; and nutrition and critical care medicine.
Submission deadline: October 15, 2019
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References
1. Eroglu A, Solak M, Ozen I, Aynaci O. Stress hormones during the wake-up test in scoliosis surgery. Journal of Clinical Anesthesia 2003;15:15-18.
2. Mauermann WJ, Shilling AM, Zuo Z. A comparison of neuraxial block versus general anesthesia for elective total hip replacement: A meta-analysis. Anesth Analg 2006;103:1018-1025.
3. Eroglu A, Uzunlar H, Erciyes N. Comparison of hypotensive epidural anesthesia and hypotensive total intravenous anesthesia on intraoperative blood loss during total hip re placement. Journal of Clinical Anesthesia 2005;17:420-425.
4. Eroglu A, Saracoglu S, Erturk E, Kosucu M, Kerimoglu S. A comparison of intraarticular morphine and bupivacaine for pain control and outpatient status after an arthroscopic knee surgery under a low dose of spinal anaesthesia. Knee Surg Sports Traumatol Arthrosc. 2010;18(11):1487-1495.
5. Kosucu M, Coskun I, Eroglu A, Kutanis D, Mentese AS, Karahan SC, et al. The effects of spinal, inhalation, and total intravenous anesthetic techniques on ischemia-reperfusion injury in arthroscopic knee surgery. BioMed Research International, Volume 2014, Article ID 846570, 7 pages. doi: 10.1155/2014/846570.
6. Saylan S, Eroglu A, Dohman D. The effects of single-dose rectal midazolam application on postoperative recovery, sedation, and analgesia in children given caudal anesthesia plus bupivacaine. Biomed Res Int 2014;2014:127548. doi: 10.1155/2014/127548.
7. Akdogan A, Eroglu A. Comparison of the Effect of Lidocaine Adding Dexketoprofenand Paracetamol in Intravenous Regional Anesthesia. BioMed Research International Volume 2014, Article ID 938108,5 pages. doi:10.1155/2014/938108.
8. Eroglu A, Uzunlar H, Sener M, et al. A clinical comparison of equal concentration and volume of ropivacaine and bupivacaine for interscalene brachial plexus anesthesia and analgesia in shoulder surgery. Reg Anesth Pain Med 2004;29:539-543.
9. Casati A, Borghi B, Fanelli G, et al. Interscalene brachial plexus anesthesia and analgesia for open shoulder surgery: A randomized, double-blinded comparison between levobupivcaine and ropivacaine. Anesth Analg 2003;96:253-259.
10. Eroglu A. A comparison of patient-controlled subacromial and i.v. analgesia after open acromioplasty surgery. Br J Anaesth 2006;96:497-501.