Our Summary

This study reviews recent research on spinal and epidural anesthesia and its effects on patients during and after surgery. These anesthesia techniques are commonly used in surgeries and while their immediate effects on pain and nervous system responses are well known, there’s still uncertainty about their longer-term effects on patient recovery.

The researchers looked at studies from 2018-2023 to see the relationship between these anesthesia techniques and standard patient recovery outcomes. They found strong evidence that epidural anesthesia, in particular, improves patient comfort after major chest and abdominal surgeries. It also seems to help prevent lung complications and reduce the risk of death.

However, they found less clear evidence that these anesthesia techniques have significant effects on other recovery outcomes, such as cancer, kidney problems, infection, or cardiovascular issues after non-heart-related surgeries. Despite some evidence suggesting these techniques could have positive effects in these areas, more research is needed to confirm these potential benefits.

FAQs

  1. What are the immediate known effects of spinal and epidural anesthesia on patients during surgery?
  2. How does epidural anesthesia affect patient recovery after major chest and abdominal surgeries?
  3. Is there any evidence to suggest that spinal and epidural anesthesia techniques can affect recovery outcomes such as cancer, kidney problems, infection, or cardiovascular issues after non-heart-related surgeries?

Doctor’s Tip

In terms of spinal surgery, a doctor might advise a patient to follow post-operative instructions carefully, including avoiding heavy lifting, engaging in physical therapy as recommended, and taking pain medication as prescribed. They may also emphasize the importance of maintaining good posture and practicing proper body mechanics to prevent further spinal issues in the future. Additionally, the doctor may recommend regular follow-up appointments to monitor the healing process and address any concerns that may arise.

Suitable For

Patients who are typically recommended spinal surgery include those with severe back or neck pain that is not responding to conservative treatments such as physical therapy, medication, or injections. Other patients may have spinal deformities, herniated discs, spinal stenosis, or spinal instability that requires surgical intervention. Additionally, patients with spinal cord compression, tumors, infections, or trauma to the spine may also be candidates for spinal surgery. Ultimately, the decision to recommend spinal surgery is based on the individual patient’s specific condition and the potential benefits and risks of the surgery.

Timeline

Before spinal surgery:

  • Patient undergoes pre-operative evaluations, including physical exams, medical history review, and possibly imaging tests.
  • Patient may attend pre-operative appointments with their surgeon, anesthesiologist, and other healthcare providers to discuss the procedure, anesthesia options, and post-operative care.
  • Patient may be instructed to stop taking certain medications, including blood thinners, in the days leading up to surgery.
  • Patient may be advised to stop eating and drinking for a certain period of time before surgery.
  • Patient may receive anesthesia before the surgery begins.

After spinal surgery:

  • Patient wakes up in the recovery room and may experience pain at the surgical site.
  • Patient may be given pain medication to manage discomfort.
  • Patient may be monitored closely for any signs of complications, such as infection, bleeding, or nerve damage.
  • Patient may be encouraged to start moving and walking soon after surgery to prevent blood clots and improve recovery.
  • Patient may be discharged from the hospital within a few days or may need to stay longer for additional monitoring and care.
  • Patient may need to attend follow-up appointments with their surgeon to monitor healing and address any concerns.
  • Patient may undergo physical therapy or rehabilitation to regain strength and mobility in the affected area.

Overall, the timeline of a patient’s experience before and after spinal surgery involves thorough preparation, careful monitoring, and ongoing support to ensure a successful recovery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with spinal surgery?
  2. How long is the recovery process expected to be after spinal surgery?
  3. What are the expected outcomes and success rates of the specific spinal surgery procedure being recommended?
  4. Are there any alternative treatment options to consider before proceeding with surgery?
  5. What will the post-operative pain management plan entail?
  6. How soon can I expect to return to normal activities and work after spinal surgery?
  7. Will physical therapy be necessary after spinal surgery, and if so, what will that entail?
  8. Are there any lifestyle changes or modifications that will need to be made following spinal surgery?
  9. What is the long-term prognosis for my spinal condition after surgery?
  10. How often will follow-up appointments be needed after spinal surgery, and what will those appointments involve?

Reference

Authors: Hewson DW, Tedore TR, Hardman JG. Journal: Br J Anaesth. 2024 Aug;133(2):380-399. doi: 10.1016/j.bja.2024.04.044. Epub 2024 May 28. PMID: 38811298