Conséquences à long terme de l'anesthésie

Long-term consequences of anaesthesia were not seriously considered until relatively recently. But there is increasing evidence that some intraoperative anaesthetic management decisions do have long-term consequences, and that others might as well. Thus, that infection risk is diminished by factors such as tissue oxygenation, adequate sympathetic block, and good control of surgical pain. An additional long-term outcome to consider is cancer. Regional anesthesia prevents the neuroendocrine stress response to surgery, reduces release of endogenous opioids and consequently, preserves NK-cell function. Furthermore, regional analgesia avoids the need for postoperative opioids, and the consequent adverse effects on immune function and of tumor growth. It reduces the metastatic burden in animal models. Paravertebral block for breast cancer surgery and epidural block for prostatic cancer surgery are associated with a reduced risk of recurrence or metastasis. Other long-term outcomes that have been and are still studied, include dangers associated with red cell transfusions, the risks and benefits of tight glycemic control, consequences of perioperative fluid management, postoperative cognitive dysfunction, anesthetic toxicity in newborns, and beta-blocker use.