General or locoregional anesthesia for high-risk patients?

High risk situations: The risk of surgery is higher in certain situations ( subjects over 70 years of age, underlying disease states). Procedures lasti ng more than 3 hours or performed in emergency situations also increase the risk. The question is often raised as to which type of anesthesia, general or locoregional, is the most appropriate to lower the risk of complication s in such situations. Anesthesia-dependent effects: Respiratory complications during or after sur gery are more frequent ii general anesthesia is used. Cardiovascular compli cations are not influenced by the type of anesthesia. Local-regional anesth esia can lower the risk of post-operative venous thrombosis and the develop ment of thrombus formation secondary to vascular surgery. it also eliminate s the neuroendocrine response to surgical stress. Modest effect: Only a few precise parameters can differentiate risk between general and locoregional anesthesia. However, the type of anesthesia has l ittle effect on overall morbidity or mortality, which depend more on the ge neral status of the patient and the surgical procedure performed.