RT Book, Section A1 Urman, Richard D. A1 LaMontagne, Patricia T. SR Print(0) ID 1205046772 T1 Spinal, Epidural, & Caudal Blocks T2 Morgan & Mikhail’s Clinical Anesthesiology Handbook YR 2024 FD 2024 PB McGraw Hill PP New York, NY SN 9781264551545 LK accessanesthesiology.mhmedical.com/content.aspx?aid=1205046772 RD 2024/11/06 AB Neuraxial blocks may reduce the incidence of venous thrombosis and pulmonary embolism, cardiac complications in high-risk patients, bleeding and transfusion requirements, vascular graft occlusion, and pneumonia and respiratory depression following upper abdominal or thoracic surgery in patients with chronic lung disease. Neuraxial blocks may also allow the earlier return of gastrointestinal function following surgery. Proposed mechanisms (in addition to precluding the need for larger doses of systemic anesthetics and opioids) include reducing the hypercoagulable state associated with surgery, increasing tissue blood flow, improving oxygenation from decreased splinting, enhancing peristalsis, and suppressing the neuroendocrine stress response to surgery. Reduction of systemic opioid administration may decrease the incidence of atelectasis, hypoventilation, and aspiration pneumonia and reduce the duration of ileus. Postoperative epidural analgesia may also significantly reduce both the need for mechanical ventilation and its duration after major abdominal or thoracic surgery.