Anesthetics and anesthesia techniques: impacts on perioperative management and postoperative outcomes

Inhaled and intravenous anesthetic agents have diverse effects on the nervous, cardiovascular, and respiratory systems. Spinal and epidural anesthetics also produce significant physiologic changes. Some evidence points to improved immediate postoperative outcomes (in terms of cardiovascular outcomes, blood loss, and venous thromboembolism) for certain types of surgical procedures with epidural and spinal techniques relative to general anesthesia. Evidence is just beginning to emerge, however, on the relation between specific anesthetics and anesthetic techniques and long-term clinical outcomes. A proposed relationship between anesthetics, inflammation, and long-term outcomes has attracted increasing research interest but has yet to be well defined.