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RA Vs GA..part 2



The evidence regarding regional techniques compared with general anesthesia has been reviewed with respect to several outcomes. Seven studies of neuraxial block and six trials of peripheral nerve catheters that measured induction time showed an increase by 8 to 9 minutes in induction time associated with regional techniques.


 Two of the studies showed that blocks performed in an induction room outside the operating room during the room turnover process could allow for the total anesthesia time to be competitive with general anesthesia.Two other studies looking at the utilization of block rooms showed actual reduction in induction time.


The use of rapid-acting drugs, such as 2-chloroprocaine, and the presence of experienced anesthesiologists also appear to reduce the additional time required for regional techniques.


 Nevertheless, the overall data indicate that there is greater time required for the performance of blocks and the onset of satisfactory analgesia.


 Brown AR, Weiss R, Greenberg C, et al: Interscalene block for shoulder arthroscopy: Comparison with general anesthesia. Arthroscopy  1993; 9:295-300.
D'Alessio JG, Rosenblum M, Shea KP, Freitas DG: A retrospective comparison of interscalene block and general anesthesia for ambulatory surgery shoulder arthroscopy. Reg Anesth  1995; 20:62-68.
 Armstrong KP, Cherry RA: Brachial plexus anesthesia compared to general anesthesia when a block room is available. Can J Anaesth  2004; 51:41-44.
Williams BA, Kentor ML, Williams JP, et al: Process analysis in outpatient knee surgery: Effects of regional and general anesthesia on anesthesia-controlled time. Anesthesiology  2000; 93:529-538.
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