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Chapter 66. Regional Anesthesia and Perioperative Outcome

One outcome advantage of regional anesthesia over general anesthesia involves:

A. Higher billing compliance

B. 10 times lower rate of prostate cancer

C. Elimination of anesthesia-induced metastatic brain cancer

D. Reducing the hypothalamic-pituitary-adrenal axis activation and subsequent immune suppression

D is correct. General anesthesia is worse from an oncologic standpoint when compared to sedation or regional anesthesia.1

Pain itself has what impact on the immune system?

A. Counteracts opioid-induced immune suppression

B. Suppresses natural killer (NK) cell function

C. Reduces immune-related cancer metastasis

D. Possesses cytotoxic properties

B is correct. Pain suppresses NK cell function.2

Epidural for thoracotomy surgery has what affect post-procedure?

A. Significantly lower rates of post-thoracotomy pain at 6 months post-procedure

B. Slightly lower rates of post-thoracotomy pain at 6 months post-procedure

C. Thoracotomy pain is not affected after 1 month post-procedure.

D. Thoracotomy pain decreases initially in the first week and then remains the same.

A is correct. Epidural has a both a short-term and long-lasting advantage when used for thoracotomy.3

Some economic benefits of regional anesthesia are:

A. Larger bundled payments

B. Higher billing compliance

C. Both shorter length of hospital stay and lower resource utilization

D. Quicker time to rehabilitation facilities and shorter turnover time

C is correct. Hospitals and patients benefit from regional anesthesia as length of stay and resource utilization goes down.4

Major perioperative outcome improvements related to regional anesthesia include:

A. Decreased rate of mechanical ventilation and blood transfusion

B. 10 times lower rate of deep vein thrombosis

C. Shorter stay in rehabilitation facilities

D. Decreased number of aneurysm ruptures

A is correct. With regional anesthesia, decreased blood loss from a sympatholytic effect occurs, and there is better pulmonary function, which ...

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