Predicting orthopedic surgeons' preferences for peripheral nerve blocks for their patients

Area of Science:

• Orthopedic Surgery
• Anesthesiology
• Regional Anesthesia

Background:

• A 2002 survey identified "delays in operating rooms" and "unpredictable success" as key barriers to regional anesthesia adoption among Canadian orthopedic surgeons.
• This study reanalyzed survey data to assess the predictive power of these concerns on surgeon willingness to use peripheral nerve blocks (PNBs).

Purpose of the Study:

• To evaluate whether surgeon perceptions of time delays and success rates predict their utilization of PNBs for patient care.
• To determine the relationship between a surgeon's personal preference for PNBs and their preference for using PNBs in patients.

Main Methods:

• Reanalysis of data from a 2002 survey of 468 Canadian orthopedic surgeons.
• Focus on three procedures: arthroscopic shoulder surgery, anterior cruciate ligament reconstruction, and total knee replacement.

Main Results:

• Surgeon preference for PNBs for themselves was a strong predictor of their preference for patients (P < 0.001) across all procedures.
• Perceptions of block "times to perform" and "success rate" showed minimal incremental predictive value (P > 0.24).
• 37% of surgeons would opt for PNBs for some, but not all, of the studied procedures for personal use.

Conclusions:

• A surgeon's personal preference for PNBs is the primary determinant of their use in patient care.
• Concerns regarding time and success rates do not significantly influence PNB adoption beyond personal preference.
• Findings are crucial for accurately forecasting the economic impact of regional anesthesia services.