Impact of Alcohol Consumption on Regional and General Anaesthesia: A Narrative Review

Alcohol use has a profound impact on the anaesthesiology practice, affecting the safety and efficacy of general and regional anaesthesia. Ethanol is a Central Nervous System (CNS) depressant that modifies the pharmacokinetics and pharmacodynamics of anaesthetic drugs through multiple drug interactions. Chronic alcohol consumption stimulates hepatic enzymes like cytochrome P450, enhancing the metabolism of anaesthetic agents. This can make them less effective, necessitating increased doses to produce the desired effect, and increase the risk of toxicity as a result of the formation of toxic metabolites. On the other hand, acute alcohol consumption can depress hepatic enzyme activity, leading to delayed drug elimination, prolonged anaesthetic action, and increased risk of adverse effects like respiratory depression and delayed recovery from anaesthesia. These drugrelated changes require judicious perioperative planning and personalised anaesthetic management. The extent of this review is to analyse the effect of ethanol upon the clinical use of anaesthesia, with emphasis on regional versus general techniques. It will discuss how alcohol influences preoperative evaluation, such as liver function and risk of withdrawal, intraoperative medication dosing, haemodynamic stability, and selection of anaesthetic drugs. In addition, it takes postoperative considerations into account, including prolonged sedation, changed pain response, and alcohol withdrawal complications. Comparing regional and general anaesthesia in alcohol consumers with different patterns of alcohol consumption, this review seeks to accentuate optimal practices for maximising anaesthetic care. It is vital to understand these interactions in order to minimise perioperative complications as well as to enhance patient outcomes. In conclusion, increased awareness and individualised strategies for anaesthetic care in alcoholimpaired patients are necessary parts of safe and successful surgery.