Evidence-Based Anesthesia for Major Gynecologic Surgery

Jeanette Bauchat, Ashraf S. Habib*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

23 Scopus citations

Abstract

Studies on enhanced recovery after gynecological surgery are limited but seem to report outcome benefits similar to those reported after colorectal surgery. Regional anesthesia is recommended in enhanced recovery protocols. Effective regional anesthetic techniques in gynecologic surgery include spinal anesthesia, epidural analgesia, transversus abdominis plane blocks, local anesthetic wound infusions and intraperitoneal instillation catheters. Non-opioid analgesics including pregabalin, gabapentin, NSAIDs, COX-2 inhibitors, and paracetamol reduce opioid consumption after surgery. This population is at high risk for PONV, thus, a multimodal anti-emetic strategy must be employed, including strategies to reduce the baseline risk of PONV in conjunction with combination antiemetic therapy.

Original languageEnglish (US)
Pages (from-to)173-207
Number of pages35
JournalAnesthesiology Clinics
Volume33
Issue number1
DOIs
StatePublished - Mar 1 2015

Keywords

  • ERAS
  • Enhanced recovery
  • Fast track
  • Gynecologic surgery

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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