Utilization of Novel Anesthesia Techniques in Organ-Sparing Surgeries

Abstract

The most significant factor is the potential improvement in morbidity rates achieved by the utilization of these anesthetic techniques. This is quite obviously cost-effective for the healthcare system and, more importantly, better for the patient. This can be exemplified in a patient undergoing a laparotomy for bowel resection. This inevitably involves a transverse abdominal incision, often from the xiphisternum to the pubis, as this is the best way to access the whole bowel. These incisions are quite painful, and if the patient has had a general anesthetic, the postoperative pain from PCA required for effective pain relief may hinder respiratory function and thus jeopardize the patient's safety. Compare this with a small incision and laparoscopic approach under local infiltration for a cholecystectomy. The cholecystectomy patient will have a much lower pain intensity, will feel less traumatized by the operation, and will return to normal life quicker than the patient undergoing the laparotomy. This may not necessarily be better for the cholecystectomy patient, but when considering the patient as a part of the healthcare population, it is a more cost-effective and sensible option. Fearing et al. have shown the cost-effectiveness of local or regional anesthesia for inguinal hernia repair compared with general anesthesia. They state that it is a safe and effective approach and that the cost savings provide an attractive alternative to the methods usually used. The present study objectively discusses the pros and cons of anesthesia techniques and their importance in the process of organ-saving surgery. When evaluating anesthetic techniques in such surgeries, the key benefits of reduced perioperative psychological pain, retained body image integrity, a shortened length of stay, and the ultimate reduction of healthcare costs may be best realized. These techniques include regional anesthesia, conscious sedation, or general anesthesia with intravenous or local infiltration of the surgical site. The optimal technique may have positive and negative consequences, which will all be discussed relative to specific surgical procedures.