Influence of regional anaesthesia on postoperative morbidity

A short review on the influence of regional anaesthesia on various parameters of postoperative morbidity is given. Only data from controlled studies have contributed to the conclusions. It appears that regional anaesthesia with local anaesthetics reduces intraoperative blood loss and postoperative thromboembolic complications after hip surgery and prostatectomy, while data from other procedures are inconclusive. Mortality is probably minimized by regional anaesthesia after acute hip surgery. No firm conclusion can be made with regard to the influence on postoperative cardial or pulmonary complications, mental dysfunction, infective complications, restoration of gastro-intestinal function as well as on convalescence, but several pieces of evidence from studies including only a limited number of patients suggest that regional anaesthesia may mitigate various aspects of postoperative morbidity. Future studies should be directed to give final answers on these points and furthermore consider the possible differing effect of a single dose infiltration anaesthesia or spinal anaesthesia versus continuous epidural analgesia, the optimal duration and extent of the neuronal block, and the effect of postoperative pain relief by epidural opiate administration.