The Impact of Anesthetic Modality Selection on Surgical Outcomes in Trauma Management
DOI:
https://doi.org/10.12775/QS.2025.38.58209Keywords
carbon footprint, general anesthesia, local anesthesia, POCDAbstract
The selection of anesthesia during surgical management of injuries is of paramount importance in ensuring patient comfort, procedural safety, and optimal surgical outcomes. The determination of the anesthetic modality is made by the anesthesiologist in consultation with the surgical team, taking into consideration the patient's medical status, the nature and extent of the injury, the anticipated duration of the procedure, and, when feasible, the patient’s preferences.
References
1. Miller, R. D. (2019). Miller's Anesthesia (9th ed.). Elsevier.
2. Barash, P. G., Cullen, B. F., & Stoelting, R. K. (2017). Clinical Anesthesia (8th ed.). Wolters Kluwer.
3. Macintyre, P., & Walker, D. (2020). Pain Management: A Practical Guide for Clinicians (5th ed.). Elsevier.
4. Jones, G. M., & Smith, G. (2018). "Anesthesia in High-Risk Surgical Patients." British Journal of Anaesthesia, 121(1), 115-121.
5. Wolf, A., Selpien, H., Haberl, H. et al. Does a combined intravenous-volatile anesthesia offer advantages compared to an intravenous or volatile anesthesia alone: a systematic review and meta-analysis. BMC Anesthesiol 21, 52 (2021). https://doi.org/10.1186/s12871-021-01273-1
6. Evered LA, Chan MTV, Han R, Chu MHM, Cheng BP, Scott DA, Pryor KO, Sessler DI, Veselis R, Frampton C, Sumner M, Ayeni A, Myles PS, Campbell D, Leslie K, Short TG. Anaesthetic depth and delirium after major surgery: a randomised clinical trial. Br J Anaesth. 2021 Nov;127(5):704-712. doi: 10.1016/j.bja.2021.07.021. Epub 2021 Aug 28. PMID: 34465469; PMCID: PMC8579421.
7. Malik SH, Saleem H, Ashfaq AD, Malik IH, Batool F, Siddique K. General Anaesthesia Versus Regional Anaesthesia For Lumbar Laminectomy: A Review Of The Modern Literature. J Ayub Med Coll Abbottabad. 2020 Jul-Sep;32(3):400-404. PMID: 32829559.)
8. Riley С, A. J. Inadvertent perioperative hypothermia BJA Education, 2018. v. 18 (8). P. e227-e233. doi, 10
9. Fernandez-Bustamante A, Frendl G, Sprung J, et al. Postoperative Pulmonary Complications, Early Mortality, and Hospital Stay Following Noncardiothoracic Surgery: A Multicenter Study by the Perioperative Research Network Investigators. JAMA Surg. 2017;152(2):157–166. doi:10.1001/jamasurg.2016.4065
10. Miskovic, A., & Lumb, A. B. (2017). Postoperative pulmonary complications. BJA: British Journal of Anaesthesia, 118(3), 317-334.
11. Czyż-Szypenbejl, K., Mędrzycka-Dąbrowska, W., Kwiecień-Jaguś, K., and Lewandowska, K. (2019). The Occurrence of Postoperative Cognitive Dysfunction (POCD) – Systematic Review. Psychiatria Polska, 53(1), pp.145-160. https://doi.org/10.12740/PP/90648
12. Evered, L. A., & Silbert, B. S. (2018). "Postoperative cognitive dysfunction: What we know, what we don't know, and what we need to know." Journal of Clinical Anesthesia, 49, 1-9.
13. Radkowski,P., Fadrowska-Szleper.,M (2023) Neurological Complication of Regional Anesthesia: An Updated Review with Clinical Guidelines, Medical Science Monitor, [online] 29
14. Owczuk.R . 2021. Anestezjologia i intensywna terapia. PZWL Wydawnictwo lekarskie
15. Liu H, Zhong H, Zubizarreta N, et alMultimodal pain management and postoperative outcomes in inpatient and outpatient shoulder arthroplasties: a population-based studyRegional Anesthesia & Pain Medicine Published Online First: 18 March 2024. doi: 10.1136/rapm-2023-104984
16. Afshan, G., Khan, R.I., Ahmed, A. et al. Post-operative pain management modalities employed in clinical trials for adult patients in LMIC; a systematic review. BMC Anesthesiol 21, 160 (2021). https://doi.org/10.1186/s12871-021-01375-w
17. Alan S. Go, Warren S. Browner; Cardiac Outcomes after Regional or General Anesthesia: Do We Have the Answer?. Anesthesiology 1996; 84:1–2 doi: https://doi.org/10.1097/00000542-199601000-00001
18. Jiang T, Ting A, Leclerc M, et al. (October 15, 2021) Regional Anesthesia in Cardiac Surgery: A Review of the Literature. Cureus 13(10): e18808. doi:10.7759/cureus.18808
19. Lim, G. What is new in Obstetric Anesthesia in 2020: a focus on research priorities for maternal morbidity, mortality, and postpartum health. International Journal of Obstetric Anesthesia, Volume 51, 103568
20. DelPizzo K, Luu T, Fields KG, Sideris A, Dong N, Edmonds C, Zayas VM. Risk of Postdural Puncture Headache in Adolescents and Adults. Anesth Analg. 2020 Jul;131(1):273-279. doi: 10.1213/ANE.0000000000004691. PMID: 32058449; PMCID: PMC8335938.
21. Ryan M. Norman, June M. Chan, Deirdre C. Kelleher; Carbon Footprint of Anesthesia: Comment. Anesthesiology 2022; 137:117–118 doi: https://doi.org/10.1097/ALN.0000000000004228
22. Lam KK, Soneji N, Katzberg H, Incidence and etiology of postoperative neurological symptoms after peripheral nerve block: A retrospective cohort study: Reg Anesth Pain Med, 2020; 45(7); 495-504
23. Yurgil JL, Hulsopple CD, Leggit JC, Nerve blocks: Part I. Upper extremity: Am Fam Physician, 2020; 101(11); 654-64
24. Galos DK, Taormina DP, Crespo A, Ding DY, Sapienza A, Jain S, Tejwani NC. Does Brachial Plexus Blockade Result in Improved Pain Scores After Distal Radius Fracture Fixation? A Randomized Trial. Clin Orthop Relat Res. 2016 May;474(5):1247-54. doi: 10.1007/s11999-016-4735-1. Epub 2016 Feb 11. PMID: 26869374; PMCID: PMC4814435.
25. Baenziger B, Nadi N, Doerig R, Proemmel P, Gahl B, Hodel D, Hausmann ON. Regional Versus General Anesthesia: Effect of Anesthetic Techniques on Clinical Outcome in Lumbar Spine Surgery: A Prospective Randomized Controlled Trial. J Neurosurg Anesthesiol. 2020 Jan;32(1):29-35. doi: 10.1097/ANA.0000000000000555. PMID: 30334934.
26. AlMutiri WA, AlMajed E, Alneghaimshi MM, AlAwadh A, AlSarhan R, AlShebel MN, AlMatrody RAM, Hadaddi R, AlTamimi R, Bin Salamah R, AlZelfawi LA, AlBatati SK, AlHarthi A, AlMazroa G, AlHossan AM. Efficacy of Continuous Lumbar Plexus Blockade in Managing Post-Operative Pain after Hip or Femur Orthopedic Surgeries: A Systematic Review and Meta-Analysis. J Clin Med. 2024 May 29;13(11):3194. doi: 10.3390/jcm13113194. PMID: 38892904; PMCID: PMC11173339.
27. Kendrišić,M. Surbatovic,M: Surgical stress response following hip arthroplasty regarding choice of anesthesia and postoperative analgesia ojnosanitetski pregled 2017 Volume 74, Issue 12, Pages: 1162-1169
https://doi.org/10.2298/VSP160416153K
28. Graff V, Gabutti L, Treglia G, Pascale M, Anselmi L, Cafarotti S, La Regina D, Mongelli F, Saporito A. Perioperative costs of local or regional anesthesia versus general anesthesia in the outpatient setting: a systematic review of recent literature. Braz J Anesthesiol. 2023 May-Jun;73(3):316-339. doi: 10.1016/j.bjane.2021.09.012. Epub 2021 Oct 7. PMID: 34627828; PMCID: PMC10240220.
29. Aman Mahajan, Stephen A. Esper, Daniel J. Cole, Lee A. Fleisher; Anesthesiologists’ Role in Value-based Perioperative Care and Healthcare Transformation. Anesthesiology 2021; 134:526–540 doi: https://doi.org/10.1097/ALN.0000000000003717
30. Amolpreet S. Toor; Preanesthesia Anxiety. Anesthesiology 2021; 135:368–369 doi: https://doi.org/10.1097/ALN.0000000000003836
31. Velkers C, Berger M, Gill SS, Eckenhoff R, Stuart H, Whitehead M, Austin PC, Rochon PA, Seitz D. Association Between Exposure to General Versus Regional Anesthesia and Risk of Dementia in Older Adults. J Am Geriatr Soc. 2021 Jan;69(1):58-67. doi: 10.1111/jgs.16834. Epub 2020 Oct 6. PMID: 33025584; PMCID: PMC7942805.
32. Outterson R. What do we know about the environmental benefits of regional anesthesia? ASRA Pain Medicine News 2023;48. https://doi.org/10.52211/asra050123.006.
33. Mancel L, Van Loon K, Lopez AM. Role of regional anesthesia in Enhanced Recovery After Surgery (ERAS) protocols. Curr Opin Anaesthesiol. 2021 Oct 1;34(5):616-625. doi: 10.1097/ACO.0000000000001048. PMID: 34325463.
34. Jadin, S.M.M., Langewitz, W.,R Voygt, D Effect of Structured Pre-anesthetic Communication on Preoperative Patient Anxiety. January 2017 Journal of Anesthesia & Clinical Research 8(10) DOI:10.4172/2155-6148.1000767
35. Liu, JunYan & Shi, ChongLai & Wang, Dan & Cui, XiaoDong & Geng, LiLi & Cui, JingJing & Sun, DongMei & Yin, Zhuo. (2024). Effects of different anesthesia methods on labor process and postpartum serum estrogen and progesterone levels in primiparas with painless labor. Clinics (Sao Paulo, Brazil). 79. 100442. 10.1016/j.clinsp.2024.100442.
36. Li, Pan & Ma, Xiaoting & Han, Shuang & Kawagoe, Izumi & Ruetzler, Kurt & Lal, Amos & Cao, Longlu & Duan, Ran & Li, Jianli. (2023). Risk factors for failure of conversion from epidural labor analgesia to cesarean section anesthesia and general anesthesia incidence: an updated meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine. 36. 2278020. 10.1080/14767058.2023.2278020.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Anna Nowak, Piotr Dudziak, Maria Golińska, Wojciech Maj, Mateusz Łyko, Jakub Kurasz, Paweł Siudziński, Alicja Skoczylas, Wiktoria Tomaszewska, Katarzyna Pala, Wiktoria Podlasiewicz

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 34
Number of citations: 0