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Published on: May 26, 2023
Regional anaesthesia for ambulatory surgery
Kristof Nijs1, Joke Ruette2, Marc Van de Velde3
1Department of Anaesthesiology and Pain Medicine, Jessa Hospital, Hasselt, Belgium; UHasselt, Faculty of Medicine and Life Sciences, Diepenbeek, Belgium; KULeuven, Department of Cardiovascular Sciences, Leuven, Belgium; Department of Anaesthesiology and Pain Medicine, University Hospitals Leuven, Leuven, Belgium.
Regional anaesthesia (RA) enhances ambulatory surgery, offering primary anesthesia and pain relief. Combining long-acting local anesthetics with dexamethasone provides optimal, extended sensory block for better patient recovery.
Area of Science:
- Anesthesiology
- Surgical Procedures
Background:
- Regional anaesthesia (RA) is increasingly vital in ambulatory surgery.
- Current local anesthetics have limited duration, impacting postoperative pain control.
- Practices for RA vary based on institutional resources and anesthesiologist preferences.
Purpose of the Study:
- To review current practices and advancements in regional anaesthesia for ambulatory surgery.
- To explore additives that prolong the effects of regional anaesthetics.
- To provide an update on local anaesthesia drugs, adjuvants, and pediatric applications.
Main Methods:
- Literature review of regional anaesthesia techniques and adjuncts for ambulatory settings.
- Analysis of evidence for long-acting local anaesthetics and adjuvants like dexamethasone.
- Discussion of paediatric regional anaesthesia and the impact of COVID-19.
Main Results:
- Peripheral nerve blocks with long-acting local anaesthetics and dexamethasone show promising extended sensory block duration.
- Various RA techniques are suitable for ambulatory surgery, with options for primary anesthesia or postoperative analgesia.
- Evidence supports the use of specific additives to enhance RA efficacy and duration.
Conclusions:
- Optimizing regional anaesthesia in ambulatory care requires careful selection of blocks and adjuvants.
- Long-acting local anaesthetics combined with dexamethasone represent a significant advancement for postoperative pain management.
- Further research and standardized protocols can improve the application and outcomes of RA in ambulatory surgery.
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