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Chapter 67. The Effects of Regional Anesthesia on Functional Outcome After Surgery
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Which of the following is true of chronic pain after surgery?
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A. After thoracotomy or limb amputation, 40% of patients suffer from persistent pain.
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B. After cesarean delivery, 25% of patients develop persistent pain.
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C. Risk of chronic pain after inguinal hernia surgery is about 33%.
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D. Chronic pain is defined as pain beyond 8 months.
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A is correct. Post-thoracotomy pain and phantom limb pain still occur frequently despite multimodal analgesic techniques.1,2
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Which of the following is true regarding regional anesthesia after major joint replacement surgery?
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A. Short-term gains in function are usually sustained in the long run.
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B. Early mobilization is helpful but not a central part of long-term joint function.
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C. Gains in passive joint range of motion due to regional anesthesia last for several months after surgery.
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D. Anesthesia that lasts more than 24 hours worsens outcome due to stretch injury.
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C is correct. Regional anesthesia for joint replacement allows for better joint flexibility. It could be due to improved rehabilitation, lower pain scores, or better operating conditions.3,4
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Regional anesthesia may impact postoperative cognitive dysfunction (POCD). Which of the following statements is true about POCD?
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A. It independently predicts adverse outcomes but not mortality increases.
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B. It independently predicts long-term cognitive impairment.
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C. It is associated with similar health care costs compared to patients without it.
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D. Morbidity increases but mortality does not.
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B is correct. POCD is very debilitating and is a risk factor for long-term cognitive deterioration.5
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Research papers comparing regional versus general anesthesia for postoperative cognitive dysfunction (POCD) have limitations and show what findings?
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A. Long-term cognitive function was not significantly different.
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B. Midazolam does not have affects on POCD.
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C. Short-term cognitive impairment was similar in both groups.
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D. Regional benefits on POCD depend the most on gender.
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A is correct. Evidence is weak when examining regional anesthesia and POCD. Current evidence does not find a ...