PERSPECTIVE article
Front. Neurosci.
Sec. Gut-Brain Axis
This article is part of the Research TopicReviews In Gut-Brain Axis – The Enteric Nervous System PerspectiveView all articles
Reconceptualizing regional anesthesia as a systemic modulator: a hypothesis-driven gut–brain axis perspective
Provisionally accepted
- 1Sichuan Province Orthopedic Hospital, Chengdu, China
- 2The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
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ABSTRACT Traditionally, regional anesthesia has been considered a local analgesic technique with benefits limited to the site of blockade. However, emerging preclinical and clinical evidence indicates that it may produce systemic effects by modulating the gut-brain axis. The gut-brain axis is a bidirectional regulatory system that integrates neural, immune, endocrine, and microbial signaling and is crucial for managing perioperative stress, inflammation, and physiological balance. This perspective article examines how regional anesthesia influences the gut-brain axis through several interconnected pathways, including neural modulation, immune regulation, endocrine effects, and indirect alterations in gut microbiota. We argue for reconceptualizing regional anesthesia as a systemic modulator and discuss its potential applications in perioperative recovery and chronic disease management. We conclude by calling for interdisciplinary research and mechanism-focused clinical trials to integrate this perspective into a more holistic model of perioperative medicine.
Keywords: gut-brain axis, Neuroimmune modulation, Perioperative, regional anesthesia, translational medicine
Received: 11 Jan 2026; Accepted: 06 Feb 2026.
Copyright: © 2026 Li, Li and Qin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhi-jun Qin
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