REGIONAL AND GENERAL ANESTHESIA FOR LOWER LIMB ORTHOPEDIC SURGERY

Abstract

The choice between regional and general anesthesia for orthopedic surgery on the lower limbs is a crucial decision, with significant implications for safety and postoperative outcomes. These two anesthetic approaches have distinct advantages and disadvantages, impacting not only the effectiveness of intraoperative analgesia, but also recovery time and patient satisfaction. The medical literature has been the scene of an ongoing debate about which approach is most beneficial in different clinical contexts. Therefore, a systematic review of the literature is essential to consolidate evidence and provide a comprehensive view of this anesthetic dichotomy. Objective: To analyze and synthesize the evidence available in the scientific literature on the choice between regional and general anesthesia for orthopedic surgeries on the lower limbs. The aim is to investigate the implications of these approaches in terms of anesthetic efficacy, patient safety, recovery time and patient satisfaction. Methodology: The review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed, Scielo and Web of Science databases were used to identify articles published in the last 10 years. The descriptors used were "regional anesthesia", "general anesthesia", "orthopedic surgery", "lower limbs" and "surgical results". The inclusion criteria covered studies that directly compared regional and general anesthesia in lower limb orthopedic surgeries, while the exclusion criteria considered studies with inadequate methodologies, non-representative samples and lack of relevant data. Results: Analysis of the selected articles revealed a variety of results related to the choice between regional and general anesthesia in orthopedic surgeries on the lower limbs. Among the main topics discussed, the effectiveness of intraoperative analgesia, post-anesthesia recovery time, perioperative complications and patient satisfaction stand out. Significant differences were observed in several studies, suggesting that the choice of anesthetic approach should be personalized according to the patient's characteristics and the nature of the surgical intervention. Conclusion: This systematic review highlights the complexity in choosing between regional and general anesthesia for orthopedic surgeries on the lower limbs. Although both approaches have specific advantages, there is no single approach that fits all clinical scenarios. Personalizing the anesthetic choice based on the individual characteristics of the patient and the peculiarities of the surgical intervention is crucial. New research and clinical trials are needed to provide more specific guidance and improve clinical practice in this context.