General Considerations for Regional Anesthesia Practice

  • Edward R. Mariano
  • Karley J. Mariano


Setting up a regional anesthesia service requires a reliable and consistent product as well as a sound business plan. Technological advances in nerve stimulation, ­ultrasound guidance, and perineural catheters have led to rapid growth in the number and types of peripheral nerve block procedures available to regional anesthesia practitioners. Starting a new regional anesthesia program potentially adds monetary value to a facility’s perioperative services by improving the quality of postoperative analgesia and recovery from surgery, thereby reducing perioperative costs and offering a competitive advantage over other surgical facilities. From the patient’s perspective, a regional anesthesia program provides nonmonetary value by preventing pain and reducing the risk of nausea and vomiting after surgery. Unfortunately for anesthesiologists interested in starting a new regional anesthesia program, there are no evidence-based guidelines to follow.


Total Knee Arthroplasty Anterior Cruciate Ligament Reconstruction Nerve Block Regional Anesthesia Postoperative Pain Management 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Financial Support. Dr. Mariano is supported by the University of California, San Diego Department of Anesthesia. The contents of this chapter are solely the responsibility of the author and do not necessarily represent the official views of this entity.

Conflicts of Interest.Dr. Mariano conducts regional anesthesia workshops for Stryker Instruments and I-Flow Corporation. He has also received material research support from Stryker, Sorenson Medical, Arrow International, and B Braun. These companies have had no input into any aspect of this manuscript.


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Anesthesiology and Perioperative Care ServiceVeterans Affairs Palo Alto Health Care SystemPalo AltoUSA
  2. 2.Department of AnesthesiologyStanford University School of MedicinePalo AltoUSA
  3. 3.Pediatric Perioperative ServicesLucille Packard Children’s HospitalPalo AltoUSA

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