Impact Of Anaesthesia Choice On Mortality And Recovery In Emergency Abdominal Surgeries: A Meta-Analysis

Abstract

Management of the perioperative period, such as anaesthesia type, affects mortality and postoperative morbidities associated with emergency abdominal surgeries, which is one of the highest-risk surgeries in the world. The main objective of this meta-analysis was to assess and compare 15 peer-reviewed articles published from 2020 to 2025 on outcomes, including mortality, complications, recovery, pain management, and the feasibility of general anaesthesia compared with regional and neuraxial techniques for emergency or high-risk abdominal surgeries. Interest in awake and neuraxial anaesthesia was highlighted in the studies for patients who pose a high risk for severe hemodynamic or respiratory complications. Of the 15 works of literature, retrospective cohorts, prospective observational studies, systematic reviews, and technical reports showed that, compared with general anaesthesia, neuraxial anaesthesia was associated with fewer postoperative pulmonary complications, improved hemodynamic stability, better recovery outcomes, lower analgesic consumption, and shorter wait time to discharge, although mortality outcomes were variable. While severe sepsis, ruptured abdominal viscerum, and difficult intubation airways were noted as practical challenges to the studies, there was still high feasibility of regional anaesthesia and neuraxial, of which 15 of the articles indicated were in low-risk patients with optimum outcomes. Design of the studies presented with homogeneity, which resulted in the necessity of a semi-qualitative analysis instead of an analysis that involved the pooling of the articles due to limits in standard deviation, mean, and variation. From the literature, it was concluded that the choice of anaesthesia can change recovery outcomes, and neuraxial anaesthesia can be ideal for patients who are in emergency abdominal surgery that can be selectively identified.