Benefits and Barriers to Increasing Regional Anesthesia in Resource-Limited Settings

Building sustainable and resilient surgical systems: A narrative review of opportunities to integrate climate change into national surgical planning in the Western Pacific region

“… 45 The use of volatile anaesthetic agents could be profoundly limited by preferentially using total intravenous anaesthesia and regional anaesthesia when appropriate. 46 , 47 , 48 Regional anaesthesia could have additional advantages in low-resource and hard-to-reach settings, including cost, safety, OR efficiency, and the potential for task-shifting to non-specialist providers, 49 thereby improving access as well as sustainability. Using low fresh gas flow or closed-circuit delivery can reduce the volume of volatile gas consumed by 20%.…”

Differences in Regional Anesthesia Utilization by Hospital Region in the United States

“…In addition, a study Cozowicz et al 16 in 2016 documented the use of neuraxial anesthesia for TKA between 2006 to 2013 as 24.7%-21.3%, and the use of peripheral nerve blocks for TKA during the same time period as increasing from 10.3-20.4%. Although our study data is not strati ed on a yearly basis likely that of Cosowicz et al, our published data re ects a relatively lower rate of RA utilization for TKA (4.5%), which may be attributable to various factors including hospital urbanicity 16; 29 , resource limitations 12 , and physician training and comfort level 30 .…”

“…However, as retrospective database and prospective cohort studies continued to seek to de ne areas of distinct bene t for RA, there is a paucity of literature examining the evolution of the regional anesthesia practice over time. Without question, evolutions in both provider 12 and patient 13 comfort with RA, as well as the evolution scope of the regional practice over the past 40 years 14 , have set the stage for a progressive landscape with demonstrable variability dependent on various factors (i.e. hospital resources, provider training, patient comfort, surgeon support, setting-speci c variation 15 ).…”

Outcomes of Retrograde Intrarenal Surgery Performed Under Neuraxial vs. General Anesthesia: An Updated Systematic Review and Meta-Analysis

“…Surgery under GA also demands adequate infrastructure and equipment which may not be always available. In resource-limited countries of Sub-Saharan African and Southeast Asia, the use of regional anesthesia is beneficial as it provides access to healthcare in a cost-effective and secure environment ( 34 ). Considering the high prevalence of urolithiasis in the global population and the need for a safe and minimally invasive procedure to manage the disease, the feasibility of RIRS under a regional anesthetic technique like NA needs to be explored.…”