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Adjuvants for balanced anesthesia in ambulatory surgery
Marc Coppens1, Annelien Steenhout2, Luc De Baerdemaeker1
1University Hospital Ghent, Belgium, Faculty of Medicine and Health Sciences, Department of Basic and Applied Medical Sciences, University Ghent, Belgium.
Best Practice & Research. Clinical Anaesthesiology
|November 8, 2023
Summary
Balanced anesthesia uses adjuvant drugs to reduce opioid use and side effects. This multimodal approach optimizes pain management and patient recovery, especially in ambulatory surgery.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Balanced anesthesia involves combining hypnotics, analgesics, and neuromuscular blockers.
- Adjuvant therapy increasingly supports the analgesic component, aiming for opioid-sparing techniques due to side effects and the opioid epidemic.
Purpose of the Study:
- To review recent evidence on adjuvants in balanced general anesthesia.
- To evaluate their mechanisms of action, opioid-sparing potential, and applicability in ambulatory surgery.
Main Methods:
- Literature review focusing on recent clinical practice evidence.
- Analysis of drug mechanisms, opioid-sparing effects, and suitability for outpatient settings.
Main Results:
- Adjuvant therapies are crucial for multimodal analgesic regimens in balanced anesthesia.
- These adjuvants aim to mitigate common postoperative side effects like sore throat, nausea, and cognitive impairment.
- The review highlights drugs with different mechanisms for opioid- or hypnotic-sparing effects.
Conclusions:
- Multimodal general anesthesia with judicious use of adjuvants is key for optimizing ambulatory surgery.
- This approach addresses acute postoperative pain and reduces adverse effects, improving patient outcomes at home.
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