The benefits of using regional anesthesia are fairly well-known — nerve blocks provide excellent pain control with relatively little nausea for the patient, minimize the need for narcotics and allow surgeons to perform more complex cases on more complex patients. That said, not every ASC knows how best to incorporate regional anesthesia into their practice.
Sonia Szlyk, MD, the director of regional anesthesia for North American Partners in Anesthesia's Mid-Atlantic Division, gave a presentation on the topic June 9 at Becker's 14th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine in Chicago.
"If you care about reducing opioid usage, fast-tracking joints, improving clinical outcomes and bundled payments, as well as raising the complexity of the cases performed on an outpatient basis, there is a block for that," said Dr. Szlyk.
Highlighted below are five strategies Dr. Szlyk says ASCs should keep in mind when using regional anesthesia:
1. Avoid delays to the operating room. Identify "block patients" — those receiving regional anesthesia — on the OR schedule so they can be prioritized in the registration process. Also, ASCs should designate specific bays and equipment specifically for block patients.
2. Make sure the nerve block works. Ultrasound-guided nerve blocks can be tailored to individual patients' specific anatomy, which improves precision, efficiency and safety, and reduces muscle weakness.
3. Have trained nursing staff assist surgeons. Nurses who have taken a course on nerve blocks can help maximize efficiency, enable safety and educate patients about the pain control method.
4. Develop regional anesthesia skills. Nurses aren't the one ones who could use block training — many ASC clinicians and staff can benefit from taking a hands-on workshop or visiting an online learning site to brush up on their regional anesthesia knowledge. Additionally, ASCs can try to hire recent graduates or other young professionals with prior regional anesthesia experience.
5. Engage surgeons in the process. Surgeons should mention regional anesthesia or a "nerve block" to the patient when they are scheduling the case, so the patient is already familiar with the pain management method prior to the day of surgery. ASCs should also obtain surgeon consent before scheduling a block procedure, to avoid delays the day of the surgery.
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