WHAT KIND OF ANESTHESIA YOU WILL CHOOSE FOR YOURSELF IF YOU ARE A PATIENT:

WHAT KIND OF ANESTHESIA YOU WILL CHOOSE FOR YOURSELF IF YOU ARE A PATIENT: REGIONAL ANESTHESIA OR GENERAL ANESTHESIA?

This question was sent by email to 665 anesthesiologists in 60 countries on May 18, 1997. 45 emails returned undelivered. 72 responded (11.61%).

79.16% of them chose Regional Anesthesia while only 20.83% chose General Anesthesia. This global study is in accordance with the previous American studies which found that 68% of the anesthesiologists in 1973 preferred regional anesthesia over general anesthesia (1) and 74% in 1986 (2).

If the situation is that most of the anesthesiologists prefer regional anesthesia for themselves, why there are too many procedures done unnecessarily under general anesthesia on non-anesthesiologist patients?

I have already asked this question twice and it remained unanswered till now (3-4).

Enclosed unselected remarks written by some of the anesthesiologists who participated in this survey:

1. To be totally honest I would choose a combination of both, but if pushed I guess a local/regional with sedation ( I am a real coward).

2. It really depends...on what procedure you propose:

eg. CABG - general

carpal tunnel - local

hernia repair - field block

knee replacement - spinal

hip replacement - general

radical retropubic prostatectomy - ga. with epidural for post op pain.

So that is the long answer... I think the question is stupid...because you cannot answer it without knowing the type of surgery!

3. Your question is too broad. A mixture of regional and general is optimal - also depends on the type of procedure: CABG vs vasectomy!

4. Depends by whom, and for what!

5. Your question is far too vague. I would not have CABG under regional, but I might have a hip replacement.

6. My response: "that depends".

7. Thank you for the informations. For what concern your question...no doubt!!! REGIONAL (where feasible)!

8. It depends on the type of operation, but whenever possible, I wouyld prefer a regional anesthesia for myself.

9. I will prefer regional anesthesia wherever there is a choice...

10. My answer: I have clearly done it! I have undergone an operation on my trimalleolar fracture. I have selected spinal anesthesia. I have selected general anesthesia removing metal equipments.

11. I prefer regional with sedation. Regional is chosen for the additional sympathicolysis and the possibility of reducing pain postoperatively; sedation is appreciated as I am anxious as everyone else.

12. General, but you should suggest different operations.

13. Whether I had general or regional anaesthesia would depend on the operation, for a tonsillectomy I`d have a GA for an orthopedic procedure on a limb, regional.

14. At my age... 40 years... I would choose regional.

15. It would largely depend on the nature of the surgery, but for the lower half of the body I would probably opt for regional.

16. Regional !!!!!!!

References:

1. Katz J. A survey of anesthetic choice among anesthesiologists. Anesth Analg 1973;52:373-375

2. Broadman LM, Mesrobian R, Ruttiman U, McGill WA. Do anesthesiologists prefer a regional or a general anesthetic for themselves? Reg Anesth 1986;11:S57

3. Eldor J. Anaesthesia and public image. Anaesthesia 1995;50:270-271

4. Eldor J. Anesthesia and public image. Reg Anesth 1995;20:466

Joseph Eldor, MD

Editor, CSEN - The Global Regional Anesthesia Website