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Ambulatory surgery with long acting regional anesthesia
1Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA. Klein006@mc.duke.edu
Minerva Anestesiologica
|January 23, 2003
Summary
Long-acting peripheral nerve blocks (PNB) offer safe and effective pain management for ambulatory surgery patients. This study found a low incidence of complications and high patient satisfaction when patients were discharged with blocked extremities.
Area of Science:
- Anesthesiology
- Pain Management
- Ambulatory Surgery
Background:
- Ambulatory surgery has increased significantly, but postoperative pain management has lagged.
- Continuous peripheral nerve blocks (CPNB) and long-acting peripheral nerve blocks (PNB) are potential solutions.
- The safety of discharging patients with blocked extremities remains a concern.
Purpose of the Study:
- To prospectively evaluate the safety and efficacy of long-acting peripheral nerve blocks (PNB) in ambulatory surgery patients.
- To assess block failure rates, opioid use, patient satisfaction, and complications after discharge.
Main Methods:
- Prospective study of 2,382 patients undergoing long-acting PNB with ropivacaine for upper and lower extremity procedures.
- Data collection included block success, recovery unit opioid use, patient-reported outcomes, and post-discharge complications.
Main Results:
- Low incidence of block failure and rare opioid use in the recovery unit.
- High patient satisfaction reported.
- Low rate of accidental injury (0.2%) to the blocked extremity and rare post-discharge complications were observed.
Conclusions:
- Long-acting PNB and perineural catheter techniques are safe and effective for ambulatory anesthesia and acute pain management.
- These techniques lead to reduced postoperative pain and improved patient satisfaction.
- Successful implementation requires significant education for anesthesiologists.