"It's an area of interest that's expanding," says Dr. Schwenk. "As the
population gets older, we're dealing with patients with cardiac disease
or pulmonary disease, for whom general anesthesia isn't preferable —
either from their perspective or from ours. Some of these procedures
can be done with truncal blocks and a little bit of light sedation."
Published guidelines are scarce, because most of the techniques are
so new, says Dr. Schwenk, adding that it remains less than fully clear
exactly how the mechanism of action works. "Some of the blocks are
promising, although they need additional study," he adds. "But we
know they seem to work surprisingly well for some people."
Dr. Schwenk believes epidural analgesia is still the gold standard
when it comes to thoracic and abdominal surgery, but surgeries are
becoming less invasive with the push to get patients moving and out
faster.
"And if a patient or surgeon doesn't want an epidural, it's nice to
have an option other than just giving the patient a lot of morphine," he
adds. "It's good to have that tool in your toolbox."
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