DEFINING SURGICAL OUTCOME

DEFINING SURGICAL OUTCOME

For the purposes of this discussion, we can break down surgical
outcome into the following categories: (1) cardiovascular morbidity
(2) pulmonary morbidity, (3) neuroendocrine stress response, (4) immune
system dysfunction, (5) intraoperative blood loss, (6) thromboembolism,
(7) return of bowel function, (8) length of hospitalization and healthcare
costs, (9) development of chronic pain syndromes, and (10) mortality.
Discussion of the potential role of neural blockade techniques in preventing
chronic pain syndromes is beyond the scope of this article.
Suffice it to say that there is a growing body of animal model and
human clinical evidence to suggest that neural blockade techniques
administered throughout the perioperative period have the greatest potential
to reduce the incidence and severity of development of chronic
pain syndromes after certain surgical procedures, such as phantom limb
pain after amputation.' The major emphasis of the remainder of this
article will be on the role of EAA in cardiovascular morbidity, pulmonary
morbidity, and gastrointestinal motility, with brief discussions of the
neuroendocrine stress response, thromboembolism and blood loss, a d
immune system dysfunction.