Skip to main content

Challenges of Pain Control in Ambulatory Surgery Setting

  • Chapter
  • First Online:
Pain Control in Ambulatory Surgery Centers

Abstract

Ambulatory surgery centers (ASCs) are prevalent throughout the United States and provide benefits to both patients and healthcare systems. Accordingly, ASCs have anesthetic challenges that are unique from hospitals in providing optimal patient care. Success of these centers is predicated on same-day patient discharge while maintaining patient safety and comfort. Adequate control of analgesia and postoperative nausea and vomiting remain two fundamental challenges of achieving this goal. Regional anesthetic techniques in combination with multimodal analgesia and enhanced recovery protocols aid in this process. Failure to meet these objectives may result in delayed discharge or escalation of care resulting in hospital admission. We present an overview of the causes of inadequate analgesia in ASCs, major postoperative concerns, regional anesthetic techniques to aid in recovery and discharge, and fundamentals of appropriate discharge analgesia.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hall MJ, Schwartzman A, Zhang J, Liu X. Ambulatory surgery data from hospitals and ambulatory surgery centers: United States, 2010. Natl Health Stat Report. 2017;2017(102):1–15.

    Google Scholar 

  2. Edmonston DL, Foulkes GD. Infection rate and risk factor analysis in an orthopaedic ambulatory surgical center. J Surg Orthop Adv. 2010;19(3):174–6.

    PubMed  Google Scholar 

  3. Goldfarb CA, Bansal A, Brophy RH. Ambulatory surgical centers: a review of complications and adverse events. J Am Acad Orthop Surg. 2017;25(1):12–22.

    PubMed  Google Scholar 

  4. Rana MV, Desai R, Tran L, Davis D. Perioperative pain control in the ambulatory setting. Curr Pain Headache Rep. 2016;20(3):1–9.

    Google Scholar 

  5. Strassels SA, Chen C, Carr DB. Postoperative analgesia: economics, resource use, and patient satisfaction in an urban teaching hospital. Anesth Analg. 2002;94(1):130–7.

    PubMed  Google Scholar 

  6. Ward S, Guest C, Goodall I, Bantel C. Practice and bias in intraoperative pain management: results of a cross-sectional patient study and a survey of anesthesiologists. J Pain Res. 2018;11:561–70.

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Gan TJ. Poorly controlled postoperative pain: prevalence, consequences, and prevention. J Pain Res. 2017;10:2287–98.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Rosero EB, Joshi GP. Hospital readmission after ambulatory laparoscopic cholecystectomy: incidence and predictors. J Surg Res. 2017;219:108–15. https://doi.org/10.1016/j.jss.2017.05.071.

    Article  PubMed  Google Scholar 

  9. Ip HYV, Abrishami A, Peng PWH, Wong J, Chung F. Predictors of postoperative pain and analgesic consumption: a qualitative systematic review. Anesthesiology. 2009;111(3):657–77.

    PubMed  Google Scholar 

  10. Sinatra R. Causes and consequences of inadequate management of acute pain. Pain Med. 2010;11(12):1859–71.

    PubMed  Google Scholar 

  11. Sinnenberg LE, Wanner KJ, Perrone J, Barg FK, Rhodes KV, Meisel ZF. What factors affect physicians’ decisions to prescribe opioids in emergency departments? MDM Policy Pract. 2017;2(1):238146831668100.

    Google Scholar 

  12. Loeser JD, Schatman ME. Chronic pain management in medical education: a disastrous omission. Postgrad Med. 2017;129(3):332–5.

    PubMed  Google Scholar 

  13. Cao X, White PF, Ma H. An update on the management of postoperative nausea and vomiting. J Anesth. 2017;31(4):617–26.

    PubMed  Google Scholar 

  14. Aldrete JA, Kroulik D. A postanesthetic recovery score. Anesth Analg. 1970;49(6):924–34.

    CAS  PubMed  Google Scholar 

  15. Aldrete JA. The post-anesthesia recovery score revisited. J Clin Anesth. 1995;7(1):89–91.

    CAS  PubMed  Google Scholar 

  16. Chung F. Recovery pattern and home-readiness after ambulatory surgery. Anesth Analg. 1995;80(5):896–902.

    CAS  PubMed  Google Scholar 

  17. American society of anesthesiologists: committee on standards and practice parameters. ​Standards for postanesthesia care. 2019.

    Google Scholar 

  18. Chung F, Chan VWS, Ong D. A post-anesthetic discharge scoring system for home readiness after ambulatory surgery. J Clin Anesth. 1995;7(6):500–6.

    CAS  PubMed  Google Scholar 

  19. Jayasekera PSA, Kai A, Lawrence CM. Preoperative hypertension increases intraoperative bleeding in patients undergoing Mohs micrographic surgery. J Am Acad Dermatol. 2019;80(2):562–4. https://doi.org/10.1016/j.jaad.2018.08.005.

    Article  PubMed  Google Scholar 

  20. Kawaguchi Y, Nomi T, Fuks D, Mal F, Kokudo N, Gayet B. Hemorrhage control for laparoscopic hepatectomy: technical details and predictive factors for intraoperative blood loss. Surg Endosc. 2016;30(6):2543–51.

    PubMed  Google Scholar 

  21. Vázquez-Narvaéz KG, Ulibarri-Vidales M. The patient with hypertension and new guidelines for therapy. Curr Opin Anaesthesiol. 2019;32(3):421–6.

    PubMed  Google Scholar 

  22. Bunick CG, Aasi SZ. Hemorrhagic complications in dermatologic surgery. Dermatol Ther. 2011;24(6):537–50.

    PubMed  PubMed Central  Google Scholar 

  23. Odom-Forren J, Reed DB, Rush C. Postoperative distress of orthopedic ambulatory surgery patients. AORN J. 2017;105(5):464–77. https://doi.org/10.1016/j.aorn.2017.03.005.

    Article  PubMed  Google Scholar 

  24. Odom-Forren J, Reed DB, Rush C. Postoperative symptom distress of laparoscopic cholecystectomy ambulatory surgery patients. J Perianesthesia Nurs. 2018;33(6):801–13. https://doi.org/10.1016/j.jopan.2017.12.002.

    Article  Google Scholar 

  25. Geisler A, Dahl JB, Karlsen APH, Persson E, Mathiesen O. Low degree of satisfactory individual pain relief in postoperative pain trials. Acta Anaesthesiol Scand. 2017;61(1):83–90.

    CAS  PubMed  Google Scholar 

  26. Mehta SJ. Patient satisfaction reporting and its implications for patient care. AMA J Ethics. 2015;17(7):616–21.

    PubMed  Google Scholar 

  27. Strate C. How does patient satisfaction impact reimbursement. Access [Internet]. 2018;2–6. Available from: https://www.accessefm.com/blog/how-does-patient-satisfaction-impact-reimbursement

  28. Mazurenko O, Collum T, Ferdinand A, Menachemi N. Predictors of hospital patient satisfaction as measured by HCAHPS: a systematic review. J Healthc Manag. 2017;62(4):272–83.

    PubMed  Google Scholar 

  29. Vadivelu N, Kai AM, Kodumudi V, Berger JM. Challenges of pain control and the role of the ambulatory pain specialist in the outpatient surgery setting. J Pain Res. 2016;9:425–35.

    PubMed  PubMed Central  Google Scholar 

  30. Tewfik MA, Frenkiel S, Gasparrini R, Zeitouni A, Daniel SJ, Dolev Y, et al. Factors affecting unanticipated hospital admission following otolaryngologic day surgery. J Otolaryngol. 2006;35(4):235–41.

    PubMed  Google Scholar 

  31. Zulfiquer FA, Pattanayak K. Evaluation of unplanned admission following day surgery at a new surgical centre in London. Ambul Surg. 2009;15(4):1–4.

    Google Scholar 

  32. Porter ME. What is value in health care? N Engl J Med. 2010;363:2477–81.

    CAS  PubMed  Google Scholar 

  33. Beverly A, Kaye AD, Ljungqvist O, Urman RD. Essential elements of multimodal analgesia in enhanced recovery after surgery (ERAS) guidelines. Anesthesiol Clin. 2017;35(2):e115–43.

    PubMed  Google Scholar 

  34. Joshi GP, Kehlet H. Postoperative pain management in the era of ERAS: an overview. Best Pract Res Clin Anaesthesiol. 2019;33(3):259–67. https://doi.org/10.1016/j.bpa.2019.07.016.

    Article  PubMed  Google Scholar 

  35. Brown EN, Pavone KJ, Naranjo M. Multimodal general anesthesia: theory and practice. Anesth Analg. 2018;127(5):1246–58.

    PubMed  PubMed Central  Google Scholar 

  36. Gabriel RA, Swisher MW, Sztain JF, Furnish TJ, Ilfeld BM, Said ET. State of the art opioid-sparing strategies for postoperative pain in adult surgical patients. Expert Opin Pharmacother. 2019;20(8):949–61.

    CAS  PubMed  Google Scholar 

  37. Elvir-Lazo OL, White PF. The role of multimodal analgesia in pain management after ambulatory surgery. Curr Opin Anaesthesiol. 2010;23(6):697–703.

    PubMed  Google Scholar 

  38. Elvir-Lazo OL, White PF. Postoperative pain management after ambulatory surgery: role of multimodal analgesia. Anesthesiol Clin. 2010;28(2):217–24.

    PubMed  Google Scholar 

  39. Delegates AH of. Distinguishing Monitored Anesthesia Care (“MAC”) From Moderate Sedation/Analgesia (Conscious Sedation). 2018;1–2.

    Google Scholar 

  40. Lee JH. Anesthesia for ambulatory surgery. Korean J Anesth. 2017;70(4):398–406.

    Google Scholar 

  41. Das S, Ghosh S. Monitored anesthesia care: an overview. J Anaesthesiol Clin Pharmacol. 2015;31(1):27–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  42. Sá Rêgo MMS, Watcha MF, White PF. The changing role of monitored. 1997;1020–36.

    Google Scholar 

  43. Ardon AE, Prasad A, McClain RL, Melton MS, Nielsen KC, Greengrass R. Regional anesthesia for ambulatory anesthesiologists. Anesthesiol Clin. 2019;37(2):265–87.

    PubMed  Google Scholar 

  44. Kopp SL, Horlocker TT. Regional anaesthesia in day-stay and short-stay surgery. Anaesthesia. 2010;65(April):84–96.

    PubMed  Google Scholar 

  45. Liu SS, Strodtbeck WM, Richman JM, Wu CL. A comparison of regional versus general anesthesia for ambulatory anesthesia: a meta-analysis of randomized controlled trials. Anesth Analg. 2005;101(6):1634–42.

    PubMed  Google Scholar 

  46. Liu Y, Su M, Li W, Yuan H, Yang C. Comparison of general anesthesia with endotracheal intubation, combined spinal-epidural anesthesia, and general anesthesia with laryngeal mask airway and nerve block for intertrochanteric fracture surgeries in elderly patients: a retrospective cohort stud. BMC Anesthesiol. 2019;19(1):4–9.

    Google Scholar 

  47. Ilfeld BM. Continuous peripheral nerve blocks: a review of the published evidence. Anesth Analg. 2011;113(4):904–25.

    PubMed  Google Scholar 

  48. Ilfeld BM, Vandenborne K, Duncan PW, Sessler DI, Enneking FK, Shuster JJ, et al. Ambulatory continuous interscalene nerve blocks decrease the time to discharge readiness after total shoulder arthroplasty: a randomized, triple-masked, placebo-controlled study. Anesthesiology. 2006;105(5):999–1007.

    PubMed  Google Scholar 

  49. White PF, Issioui T, Skrivanek GD, Early JS, Wakefield C. The use of a continuous popliteal sciatic nerve block after surgery involving the foot and ankle: does it improve the quality of recovery? Anesth Analg. 2003;97(5):1303–9.

    PubMed  Google Scholar 

  50. Ilfeld BM, Enneking FK. Continuous peripheral nerve blocks at home: a review. Anesth Analg. 2005;100(6):1822–33.

    PubMed  Google Scholar 

  51. Weinschenk S, Mergenthaler C, Armstrong C, Göllner R, Hollmann MW, Strowitzki T. Local anesthetics, procaine, lidocaine, and mepivacaine show vasodilatation but no type 1 allergy: a double-blind, placebo-controlled study. Biomed Res Int. 2017;2017:1–9.

    Google Scholar 

  52. Kaur A, Bahadur Singh R, Tripathi RK, Choubey S. Comparison between bupivacaine and ropivacaine in patients undergoing forearm surgeries under axillary brachial plexus block: a prospective randomized study. J Clin Diagnostic Res. 2015;9(1):1–6.

    Google Scholar 

  53. Buckenmaier C, Kent M, Brookman J, Tighe P, Mariano E, Edwards D. Acute pain medicine. 1st ed. New York: Oxford University Press; 2019. p. 282–3.

    Google Scholar 

  54. Ribotsky BM, Berkowitz KD, Montague JR. Local anesthetics. Is there an advantage to mixing solutions? J Am Pod Med Assoc. 1996;86(10):487–91.

    CAS  Google Scholar 

  55. Cuvillon P, Nouvellon E, Ripart J, Boyer JC, Dehour L, Mahamat A, et al. A comparison of the pharmacodynamics and pharmacokinetics of bupivacaine, ropivacaine (with epinephrine) and their equal volume mixtures with lidocaine used for femoral and sciatic nerve blocks: a double-blind randomized study. Anesth Analg. 2009;108(2):641–9.

    CAS  PubMed  Google Scholar 

  56. Becker DE, Reed KL. Local anesthetics: review of pharmacological considerations. Anesth Prog. 2012;59(2):90–102.

    PubMed  PubMed Central  Google Scholar 

  57. Gadsden J. Local anesthetics: clinical pharmacology and rational selection. In: Hadzic A, editor. Hadzic’s peripheral nerve blocks and anatomy for ultrasound-guided regional anesthesia. 2nd ed. New York: McGraw-Hill; 2012. p. Chapter 2.

    Google Scholar 

  58. Cummings KC, Napierkowski DE, Parra-Sanchez I, Kurz A, Dalton JE, Brems JJ, et al. Effect of dexamethasone on the duration of interscalene nerve blocks with ropivacaine or bupivacaine. Br J Anaesth. 2011;107(3):446–53. https://doi.org/10.1093/bja/aer159.

    Article  CAS  PubMed  Google Scholar 

  59. Parrington SJ, O’Donnell D, Chan VWS, Brown-Shreves D, Subramanyam R, Qu M, et al. Dexamethasone added to mepivacaine prolongs the duration of analgesia after supraclavicular brachial plexus blockade. Reg Anesth Pain Med. 2010;35(5):422–6.

    CAS  PubMed  Google Scholar 

  60. Kirksey MA, Haskins SC, Cheng J, Liu SS. Local anesthetic peripheral nerve block adjuvants for prolongation of analgesia: a systematic qualitative review. PLoS One. 2015;10(9):e0137312.

    PubMed  PubMed Central  Google Scholar 

  61. Albrecht E, Kern C, Kirkham KR. A systematic review and meta-analysis of perineural dexamethasone for peripheral nerve blocks. Anaesthesia. 2015;70(1):71–83.

    CAS  PubMed  Google Scholar 

  62. Kirkham KR, Jacot-Guillarmod A, Albrecht E. Optimal dose of perineural dexamethasone to prolong analgesia after brachial plexus blockade: a systematic review and meta-analysis. Anesth Analg. 2018;126(1):270–9.

    PubMed  Google Scholar 

  63. Polderman JAW, Farhang-Razi V, Van Dieren S, Kranke P, Devries JH, Hollmann MW, et al. Adverse side effects of dexamethasone in surgical patients. Cochrane Database Syst Rev. 2018;2018(8):CD011940.

    PubMed Central  Google Scholar 

  64. Schnepper GD, Kightlinger BI, Jiang Y, Wolf BJ, Bolin ED, Wilson SH. A retrospective study evaluating the effect of low doses of perineural dexamethasone on ropivacaine brachial plexus peripheral nerve block analgesic duration. Pain Med. 2018;19(7):1485–93.

    PubMed  Google Scholar 

  65. Witt NJ, Zochodne DW, Bolton CF, Grand’Maison F, Wells G, Young GB, et al. Peripheral nerve function in sepsis and multiple organ failure. Chest. 1991;99(1):176–84. https://doi.org/10.1378/chest.99.1.176.

    Article  CAS  PubMed  Google Scholar 

  66. Abdallah FW, Dwyer T, Chan VWS, Niazi AU, Ogilvie-Harris DJ, Oldfield S, et al. IV and perineural dexmedetomidine similarly prolong the duration of analgesia after interscalene brachial plexus block: a randomized, three-arm, triple-masked, placebo-controlled trial. Anesthesiology. 2016;124(3):683–95.

    CAS  PubMed  Google Scholar 

  67. Sinnott CJ, Cogswell LP, Johnson A, Strichartz GR. On the mechanism by which epinephrine potentiates lidocaine’s peripheral nerve block. Anesthesiology. 2003;98(1):181–8.

    CAS  PubMed  Google Scholar 

  68. Weber A, Fournier R, Van Gessel E, Riand N, Gamulin Z. Epinephrine does not prolong the analgesia of 20 mL ropivacaine 0.5% or 0.2% in a Femoral three-in-one block. Anesth Analg. 2001;93(5):1327–31.

    CAS  PubMed  Google Scholar 

  69. Neal JM. Effects of epinephrine in local anesthetics on the central and peripheral nervous systems: neurotoxicity and neural blood flow. Reg Anesth Pain Med. 2003;28(2):124–34.

    CAS  PubMed  Google Scholar 

  70. Vadhanan P, Tripaty DK, Adinarayanan S. Physiological and pharmacologic aspects of peripheral nerve blocks. J Anaesthesiol Clin Pharmacol. 2015;31(3):384–93.

    CAS  PubMed  PubMed Central  Google Scholar 

  71. Partridge BL, Phil D. The effects of local anesthetics and epinephrine on rat sciatic nerve blood flow. Anesthesiology. 1991;75(2):243–51.

    CAS  PubMed  Google Scholar 

  72. Vorobeichik L, Brull R, Abdallah FW. Evidence basis for using perineural dexmedetomidine to enhance the quality of brachial plexus nerve blocks: a systematic review and meta-analysis of randomized controlled trials. Br J Anaesth. 2017;118(2):167–81.

    CAS  PubMed  Google Scholar 

  73. Williams BA, Hough KA, Tsui BYK, Ibinson JW, Gold MS, Gebhart GF. Neurotoxicity of adjuvants used in perineural anesthesia and analgesia in comparison with ropivacaine. Reg Anesth Pain Med. 2011;36(3):225–30.

    CAS  PubMed  PubMed Central  Google Scholar 

  74. Desai N, Albrecht E, El-Boghdadly K. Perineural adjuncts for peripheral nerve block. BJA Educ. 2019;19(9):276–82. https://doi.org/10.1016/j.bjae.2019.05.001.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Funai Y, Pickering AE, Uta D, Nishikawa K, Mori T, Asada A, et al. Systemic dexmedetomidine augments inhibitory synaptic transmission in the superficial dorsal horn through activation of descending noradrenergic control: an in vivo patch-clamp analysis of analgesic mechanisms. Pain. 2014;155(3):617–28.

    CAS  PubMed  Google Scholar 

  76. Schnabel A, Reichl SU, Zahn PK, Pogatzki-Zahn EM, Meyer-Frießem CH. Efficacy and safety of buprenorphine in peripheral nerve blocks: a meta-analysis of randomised controlled trials. Eur J Anaesthesiol. 2017;34(9):576–86.

    CAS  PubMed  Google Scholar 

  77. Bergese SD, Ramamoorthy S, Patou G, Bramlett K, Gorfine SR, Candiotti KA. Efficacy profile of liposome bupivacaine, a novel formulation of bupivacaine for postsurgical analgesia. J Pain Res. 2012;5:107–16.

    CAS  PubMed  PubMed Central  Google Scholar 

  78. Langford R, Chappell G, Karrasch J. A single administration of depobupivacaine intraoperatively results in prolonged detectable plasma bupivacaine and analgesia in patients undergoing inguinal hernia repair. In: The Annual Postgraduate Assembly in Anesthesiology of the New York State Society of Anesthesiologists. The Annual Postgraduate Assembly in Anesthesiology of the New York State Society of Anesthesiologists: New York; 2008.

    Google Scholar 

  79. White P, Schooley G, Ardeleanu M. Analgesia following a single administration of depobupivacaine intraoperatively in patients undergoing inguinal herniorrhaphy: preliminary dose-ranging studies. Anesth Analg. 2009;108(suppl 3S):S242.

    Google Scholar 

  80. Okoroha KR, Lynch JR, Keller RA, Korona J, Amato C, Rill B, et al. Liposomal bupivacaine versus interscalene nerve block for pain control after shoulder arthroplasty: a prospective randomized trial. J Shoulder Elb Surg. 2016;25(11):1742–8.

    Google Scholar 

  81. Okoroha KR, Keller RA, Marshall NE, Jung EK, Mehran N, Owashi E, et al. Liposomal bupivacaine versus femoral nerve block for pain control after anterior cruciate ligament reconstruction: a prospective randomized trial. Arthroscopy. 2016;32(9):1838–45.

    PubMed  Google Scholar 

  82. Namdari S, Nicholson T, Abboud J, Lazarus M, Steinberg D, Williams G. Randomized controlled trial of interscalene block compared with injectable liposomal bupivacaine in shoulder arthroplasty. J Bone Jt Surg. 2017;99(7):550–6.

    Google Scholar 

  83. Vandepitte C, Kuroda M, Witvrouw R, Anne L, Bellemans J, Corten K, et al. Addition of liposome bupivacaine to bupivacaine HCl versus bupivacaine HCl alone for interscalene brachial plexus block in patients having major shoulder surgery. Reg Anesth Pain Med. 2017;42(3):334–41.

    CAS  PubMed  Google Scholar 

  84. Auyong DB, Hanson NA, Joseph RS, Schmidt BE, Slee AE, Yuan SC. Comparison of anterior suprascapular, supraclavicular, and interscalene nerve block approaches for major outpatient arthroscopic shoulder surgery a randomized, double-blind, noninferiority trial. Anesthesiology. 2018;129(1):47–57.

    PubMed  Google Scholar 

  85. Neal JM, Gerancher JC, Hebl JR, Ilfeld BM, McCartney CJL, Franco CD, et al. Upper extremity regional anesthesia. Essentials of our current understanding, 2008. Reg Anesth Pain Med. 2009;34(2):134–70.

    PubMed  PubMed Central  Google Scholar 

  86. Miller B, Pawa A, Mariano E. Problem with the Pecs II block: the long thoracic nerve is collateral damage. Reg Anesth Pain Med. 2019;44(8):817–8.

    Google Scholar 

  87. Kunigo T, Murouchi T, Yamamoto S, Yamakage M. Spread of injectate in ultrasound-guided serratus plane block: a cadaveric study. JA Clin Rep. 2018;4(1):4–5.

    Google Scholar 

  88. Choi YJ, Kwon HJ, Jehoon O, Cho TH, Won JY, Yang HM, et al. Influence of injectate volume on paravertebral spread in erector spinae plane block: an endoscopic and anatomical evaluation. PLoS One. 2019;14(10):e0224487.

    CAS  PubMed  PubMed Central  Google Scholar 

  89. Tsai HC, Yoshida T, Chuang TY, Yang SF, Chang CC, Yao HY, et al. Transversus abdominis plane block: an updated review of anatomy and techniques. Biomed Res Int. 2017;2017(8284363):1–12.

    Google Scholar 

  90. Grevstad U, Jæger P, Sørensen JK, Gottschau B, Ilfeld B, Ballegaard M, et al. The effect of local anesthetic volume within the adductor canal on quadriceps femoris function evaluated by electromyography: a randomized, observer- and infject-blinded, placebo-controlled study in volunteers. Anesth Analg. 2016;123(2):493–500.

    CAS  PubMed  Google Scholar 

  91. Tran J, Chan V, Peng P, Agur A. Response to Sebastian et al: the saphenous nerve and iPACK blocks. Reg Anesth Pain Med. 2020;45(3):245–6.

    PubMed  Google Scholar 

  92. Grossi P, Urmey WF. Peripheral nerve blocks for anaesthesia and postoperative analgesia. Curr Opin Anaesthesiol. 2003;16(5):493–501.

    PubMed  Google Scholar 

  93. Gharabawy R, Abd-Elsayed A, Elsharkawy H, Farag E, Cummings K, Eid G, et al. The Cleveland clinic experience with supraclavicular and popliteal ambulatory nerve catheters. Sci World J. 2014;2014:572507.

    Google Scholar 

  94. Gurnaney H, Kraemer FW, Maxwell L, Muhly WT, Schleelein L, Ganesh A. Ambulatory continuous peripheral nerve blocks in children and adolescents: a longitudinal 8-year single center study. Anesth Analg. 2014;118(3):621–7.

    PubMed  Google Scholar 

  95. Bures E, Rivet P, Estebe JP. Échec De Retrait De Cathéters Nerveux Périphériques: Les Nœuds, Une Complication À Connaître. Ann Fr Anesth Reanim. 2009;28(5):493–5.

    CAS  PubMed  Google Scholar 

  96. Presta MV, Byram SW, Reis CL, Sniderman M. Noninvasive removal of an entrapped supraclavicular catheter. J Clin Anesth. 2012;24(4):350–2.

    PubMed  Google Scholar 

  97. Clendenen SR, Robards CB, Greengrass RA, Brull SJ. Complications of peripheral nerve catheter removal at home: case series of five ambulatory interscalene blocks. Can J Anesth. 2011;58(1):62–7.

    PubMed  Google Scholar 

  98. Warner NS, Duncan CM, Kopp SL. Acute retroperitoneal hematoma after psoas catheter placement in a patient with myeloproliferative thrombocytosis and aspirin therapy. A A Case Rep. 2016;6(2):28–30.

    PubMed  Google Scholar 

  99. Walker BJ, Long JB, De Oliveira GS, Szmuk P, Setiawan C, Polaner DM, et al. Peripheral nerve catheters in children: an analysis of safety and practice patterns from the pediatric regional anesthesia network (PRAN). Br J Anaesth. 2015;115(3):457–62.

    CAS  PubMed  Google Scholar 

  100. Bleckner L, Solla C, Fileta BB, Howard R, Morales CE, Buckenmaier CC. Serum free ropivacaine concentrations among patients receiving continuous peripheral nerve block catheters: is it safe for long-term infusions? Anesth Analg. 2014;118(1):225–9.

    CAS  PubMed  Google Scholar 

  101. Henningsen MH, Jæger P, Hilsted KL, Dahl JB. Prevalence of saphenous nerve injury after adductor-canal-blockade in patients receiving total knee arthroplasty. Acta Anaesthesiol Scand. 2013;57(1):112–7.

    CAS  PubMed  Google Scholar 

  102. Ilfeld BM. Continuous peripheral nerve blocks: an update of the published evidence and comparison with novel, alternative analgesic modalities. Anesth Analg. 2017;124(1):308–35.

    CAS  PubMed  Google Scholar 

  103. Ribeiro FC, Georgousis H, Bertram R, Scheiber G. Plexus irritation caused by interscalene brachial plexus catheter for shoulder surgery. Anesth Analg. 1996;82(4):870–2.

    CAS  PubMed  Google Scholar 

  104. Rawal N, Allvin R, Axelsson K, Hallén J, Ekbäck G, Ohlsson T, et al. Patient-controlled regional analgesia (PCRA) at home: controlled comparison between bupivacaine and ropivacaine brachial plexus analgesia. Anesthesiology. 2002;96(6):1290–6.

    CAS  PubMed  Google Scholar 

  105. Ilfeld BM, Morey TE, Enneking FK. Continuous infraclavicular brachial plexus block for postoperative pain control at home: a randomized, double-blinded, placebo-controlled study. Anesthesiology. 2002;96(6):1297–304.

    CAS  PubMed  Google Scholar 

  106. Ilfeld BM, Morey TE, Wang RD, Enneking FK. Continuous popliteal sciatic nerve block for postoperative pain control at home: a randomized, double-blinded, placebo-controlled study. Anesthesiology. 2002;97(4):959–65.

    CAS  PubMed  Google Scholar 

  107. Ilfeld BM, Morey TE, Wright TW, Chidgey LK, Enneking FK. Continuous interscalene brachial plexus block for postoperative pain control at home: a randomized, double-blinded, placebo-controlled study. Anesth Analg. 2003;96(4):1089–95.

    PubMed  Google Scholar 

  108. Denson DD, Raj PP, Saldahna F, Finnsson RA, Ritschel WA, Joyce TH, et al. Continuous perineural infusion of bupivacaine for prolonged analgesia: pharmacokinetic considerations. Int J Clin Pharmacol Ther Toxicol. 1983;21(12):591–7.

    CAS  PubMed  Google Scholar 

  109. Pere P. The effect of continuous interscalene brachial plexus block with 0.125% bupivacaine plus fentanyl on diaphragmatic motility and ventilatory function. Reg Anesth. 1993;18(2):93–7.

    CAS  PubMed  Google Scholar 

  110. Borgeat A, Dullenkopf A, Ekatodramis G, Nagy L. Evaluation of the lateral modified approach for continuous interscalene block after shoulder surgery. Anesthesiology. 2003;99(2):436–42.

    PubMed  Google Scholar 

  111. Borgeat A, Blumenthal S, Karovic D, Delbos A, Vienne P. Clinical evaluation of a modified posterior anatomical approach to performing the popliteal block. Reg Anesth Pain Med. 2004;29(3):290–6.

    PubMed  Google Scholar 

  112. Tighe P, Buckenmaier CC, Boezaart AP, Carr DB, Clark LL, Herring AA, et al. Acute pain medicine in the United States: a status report. Pain Med. 2015;16(9):1806–26.

    PubMed  Google Scholar 

  113. Bomberg H, Bayer I, Wagenpfeil S, Kessler P, Wulf H, Standl T, et al. Prolonged catheter use and infection in regional anesthesia: a retrospective registry analysis. Anesthesiology. 2018;128(4):764–73.

    PubMed  Google Scholar 

  114. Pacenta HL, Kaddoum RN, Pereiras LA, Chidiac EJ, Burgoyne LL. Continuous tunnelled femoral nerve block for palliative care of a patient with metastatic osteosarcoma. Anaesth Intensive Care. 2010;38(3):563–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  115. Macaire P, Gaertner E, Capdevila X. Continuous postoperative regional analgesia at home. Minerva Anestesiol. 2001;67(9 Suppl 1):109–16.

    CAS  PubMed  Google Scholar 

  116. Borgeat A, Kalberer F, Jacob H, Ruetsch YA, Gerber C. Patient-controlled interscalene analgesia with ropivacaine 0.2% versus bupivacaine 0.15% after major open shoulder surgery: the effects on hand motor function. Anesth Analg. 2001;92(1):218–23.

    CAS  PubMed  Google Scholar 

  117. Huang N, Cunningham F, Laurito CE, Chen C. Can we do better with postoperative pain management? Am J Surg. 2001;182(5):440–8.

    CAS  PubMed  Google Scholar 

  118. Paulozzi LJ, Jones CM, Mack KA, Rudd RA. Vital signs: overdoses of prescription opioid pain relievers — United States, 1999–2008. Morb Mortal Wkly Rep. 2011;60(43):1487–92.

    Google Scholar 

  119. Feinberg AE, Chesney TR, Srikandarajah S, Acuna SA, McLeod RS. Opioid use after discharge in postoperative patients: a systematic review. Ann Surg. 2018;267(6):1056–62.

    PubMed  Google Scholar 

  120. McDonald DC, Carlson K, Izrael D. Geographic variation in opioid prescribing in the U.S. J Pain. 2012;13(10):988–96.

    PubMed  PubMed Central  Google Scholar 

  121. Gomes T, Juurlink D, Moineddin R, Gozdyra P, Dhalla I, Paterson M, et al. Geographical variation in opioid prescribing and opioid-related mortality in Ontario. Healthc Q. 2011;14(1):22–4.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Fanelli, D., Warfield, D.J., Smith, S., Alinani, A., Kaye, A.D., Liu, H. (2021). Challenges of Pain Control in Ambulatory Surgery Setting. In: Rajput, K., Vadivelu, N., Kaye, A.D., Shah, R.V. (eds) Pain Control in Ambulatory Surgery Centers. Springer, Cham. https://doi.org/10.1007/978-3-030-55262-6_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-55262-6_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-55261-9

  • Online ISBN: 978-3-030-55262-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics