Comparative Analysis of Anesthetic Techniques in Saudi Patients: A Systematic Review

Abstract

This systematic review synthesizes evidence from 10 selected studies on the comparative efficacy, safety, and patient outcomes of various anesthetic techniques, including general anesthesia (GA), regional anesthesia (RA), local anesthesia (LA), and sedation methods, among Saudi patients undergoing elective and emergency procedures. The analysis reveals that RA is associated with quicker postoperative recovery in 52.3% of cases, reduced incidence of complications such as postoperative nausea and vomiting (PONV) observed in 70.8% of GA cases, and higher patient satisfaction rates, particularly in orthopedic, obstetric, and abdominal surgeries, where RA preferences reached up to 48.3% among healthcare professionals. In contrast, GA remains the preferred choice for 51.7% of elective surgeries due to factors like surgical complexity and patient reluctance toward RA, with multivariable logistic regression indicating lower odds of RA preference among older patients (OR=0.64, 95% CI: 0.41-0.98, p=0.041) and higher odds with adequate training (OR=1.58, 95% CI: 1.21-2.05, p=0.001). Sedation techniques, such as fentanyl-propofol versus fentanyl-midazolam infusions, demonstrated comparable sedation levels but with propofol showing faster recovery and less nausea, though amnesia rates were higher with midazolam (95% vs. 70%, p=0.091). In pediatric contexts, lidocaine was the most preferred LA (92.3%), with benzocaine topical anesthesia favored (68.2%), leading to effective pain control and reduced anxiety, while needleless jet anesthesia outperformed conventional syringes in comfort (p=0.003). Public awareness in Saudi Arabia is high for GA (91.3%) and LA (88.3%) but limited for RA techniques like spinal (15.8%) and epidural (13.1%), highlighting educational gaps that influence consent and satisfaction. Overall, RA techniques offer superior outcomes in recovery time, analgesia duration, and complication reduction, but barriers such as inadequate training (54.5%), equipment limitations (41.8%), and patient fears necessitate targeted interventions to optimize anesthetic practices in Saudi healthcare settings, ultimately enhancing perioperative safety and efficiency.