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Essentials of Regional Anesthesia pp 37–80Cite as

Regional Anesthesia in the Community Practice Setting

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Abstract

The appropriate management of pain has many benefits. Evidence for improved patient outcomes, in particular, has given physicians a popular and professional mandate to better manage pain [1]. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) now requires the recording of pain as a “5th vital sign.” Unfortunately, there is well-publicized evidence that pain continues to be inadequately managed [2, 3].

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References

  1. Hanna MN, Murphy JD, Kumar K, et al. Regional techniques and outcome: what is the evidence? Curr Opin Anaesthesiol. 2009;22:672–7.

    Article  PubMed  Google Scholar 

  2. Apfelbaum JL, Chen C, Mehta SS, et al. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003;97:534–40.

    Article  PubMed  Google Scholar 

  3. McGrath B, Elgendy H, Chung F, et al. Thirty percent of patients have moderate to severe pain 24 hr after ambulatory surgery: a survey of 5,703 patients. Can J Anesth. 2004;51:886–91.

    Article  PubMed  Google Scholar 

  4. American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting. An updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology. 2004;100:1573–81.

    Article  Google Scholar 

  5. Abouleish AE, Prough DS, Whitten CW, et al. Comparing clinical productivity of anesthesiology groups. Anesthesiology. 2002;97:608–15.

    Article  PubMed  Google Scholar 

  6. Oldman M, McCartney CJL, Leung A, et al. A survey of orthopedic surgeons’ attitudes and knowledge regarding regional anesthesia. Anesth Analg. 2004;98:1486–90.

    Article  PubMed  Google Scholar 

  7. Kopacz DJ, Neal JM. Regional anesthesia and pain medicine: residency training – the year 2000. Reg Anesth Pain Med. 2002;27:9–14.

    PubMed  Google Scholar 

  8. Heid F, Jage B, Jage J. Current practice in regional anaesthesia in Germany. Eur J Anaesthesiol. 2006;23:346–50.

    Article  PubMed  CAS  Google Scholar 

  9. Gaba DM, Howard SK, Jump B. Production pressure in the work environment. California anesthesiologists’ attitudes and experiences. Anesthesiology. 1994;81:488–500.

    Article  PubMed  CAS  Google Scholar 

  10. Matthey PW, Finegan BA, Finucane BT. The public’s fears about and perceptions of regional anesthesia. Reg Anesth Pain Med. 2004;29:96–101.

    PubMed  Google Scholar 

  11. Armstrong KPJ, Cherry RA. Brachial plexus anesthesia compared to general anesthesia when a block room is available. Can J Anesth. 2004;51:41–4.

    Article  PubMed  Google Scholar 

  12. Leskiw U, Weinberg GL. Lipid rescue for local anesthetic toxicity: is it really lifesaving? Curr Opin Anaesthesiol. 2009;22:667–71.

    Article  PubMed  Google Scholar 

  13. White PF, Kehlet H. Improving postoperative pain management. What are the unresolved issues? Anesthesiology. 2010;112:220–5.

    Article  PubMed  Google Scholar 

  14. Liu SS, John RS. Modeling cost of ultrasound versus nerve stimulator guidance for nerve blocks with sensitivity analysis. Reg Anesth Pain Med. 2010;35:57–63.

    Article  PubMed  Google Scholar 

  15. Frederickson M et al. Successful continuous interscalene analgesia for ambulatory shoulder surgery in a private practice setting. Reg Anesth Pain Med. 2008;33:122–8.

    Google Scholar 

  16. Kahn RL, Nelson DA. Regional anesthesia group practice in multihospital private practice settings and in orthopedic specialty hospitals. Int Anesthesiol Clin. 2005;43:15–24.

    Article  PubMed  Google Scholar 

  17. Masursky D et al. Predicting orthopedic surgeons’ preference for peripheral nerve blocks for their patients. Anesth Analg. 2008;106:561–7.

    Article  PubMed  Google Scholar 

  18. Rupp T, Delaney KA. Inadequate analgesia in emergency medicine. Ann Emerg Med. 2004;43:494–503.

    Article  PubMed  Google Scholar 

  19. Foss NB, Kristensen BB, Bundgaard M, et al. Fascia iliaca compartment blockade for acute pain control in hip fracture patients: a randomized, placebo-controlled trial. Anesthesiology. 2007;106:773–8.

    Article  PubMed  CAS  Google Scholar 

  20. Viscusi ER, Rehanna J, Warshawsky D. An acute pain management service with regional anesthesia: how to make it work. Tech Reg Anesth Pain Man. 2002;6:40–9.

    Article  Google Scholar 

  21. Sharma V, Morgan PM, Cheng EY. Factors influencing early rehabilitation after THA. A systematic review. Clin Orthop Relat Res. 2009;467:1400–11.

    Article  PubMed  Google Scholar 

  22. Hebl JR, Dilger JA, Byer DE, et al. A pre-emptive multimodal pathway featuring peripheral nerve block improves postoperative outcomes after major orthopedic surgery. Reg Anesth Pain Med. 2008;33:510–7.

    PubMed  Google Scholar 

  23. Schug SA, Manopas A. Update on the role of non-opioids for postoperative pain treatment. Best Pract Res Clin Anaesthesiol. 2007;21:15–30.

    Article  PubMed  CAS  Google Scholar 

  24. Liu SS, Richman JM, Thirlby RC, et al. Efficacy of continuous wound catheters delivering local anesthetic for postoperative analgesia: a quantitative and qualitative systematic review of randomized controlled trials. J Am Coll Surg. 2006;203:914–32.

    Article  PubMed  Google Scholar 

  25. Gupta A, Bodin L, Holmstrom B, et al. A systematic review of the peripheral analgesic effects of intraarticular morphine. Anesth Analg. 2001;93:761–70.

    Article  PubMed  CAS  Google Scholar 

  26. Buvanendran A, Kroin JS, Della Valle CJ, et al. Perioperative oral pregabalin reduces chronic pain after total knee arthroplasty: a prospective, randomized, controlled trial. Anesth Analg. 2010;110:199–207.

    Article  PubMed  CAS  Google Scholar 

  27. Barbieri A, Vanhaect K, Van Herck P, et al. Effects of clinical pathways in the joint replacement: a meta-analysis. BMC Med. 2009;7:32.

    Article  PubMed  CAS  Google Scholar 

  28. Lennon RL, Horlocker TT. Mayo Clinic analgesic pathway: Peripheral nerve blockade for major orthopedic surgery. Florence, KY: Taylor and Francis Group; 2006.

    Google Scholar 

  29. Walter FL, Bass N, Bock G, et al. Success of clinical pathways for total joint arthroplasty in a clinical hospital. Clin Orthop Rel Res. 2006;457:133–7.

    Google Scholar 

  30. Fisher HB, Simanski CJ, Sharp C, et al. A procedure-specific systematic review and concensus recommendations for postoperative analgesia following total knee arthroplasty. Anaesthesia. 2008;63:1105–23.

    Article  Google Scholar 

  31. Pham Dang C, Gautheron E, Guilley J, et al. The value of adding sciatic block to continuous femoral block for analgesia after total knee replacement. Reg Anesth Pain Med. 2005;30:128–33.

    Article  PubMed  Google Scholar 

  32. Lecamwasam H, Mayfield J, Rosow L, et al. Stimulation of the posterior cord predicts successful infraclavicular block. Anesth Analg. 2006;102:1564–8.

    Article  PubMed  Google Scholar 

  33. Arcioni R, Palmisani S, Della Valle CJ, et al. Lateral popliteal sciatic nerve block: a single injection targeting the tibial branch of the sciatic nerve is as effective as a double-injection technique. Acta Anaesthesiol Scand. 2007;51:115–21.

    Article  PubMed  CAS  Google Scholar 

  34. Wiegel M, Reske A, Hennebach R, et al. Anterior sciatic nerve block – new landmarks and clinical experience. Acta Anaesthesiol Scand. 2005;49:522–7.

    Article  Google Scholar 

  35. Hargett MJ, Beckman JD, Ligouri GA, et al. Guidelines for regional anesthesia fellowship training. Reg Anesth Pain Med. 2005;30:218–25.

    PubMed  Google Scholar 

  36. Kapral S, Marhofer P, Grau T. Ultrasound in local anesthesia. Part 1: Technical developments and background. Anaesthetist. 2002;51:931–7.

    Article  CAS  Google Scholar 

  37. Griffin J, Nicholls B. Ultrasound in regional anesthesia. Anaesthesia. 2010;65 Suppl 1:1–12.

    Article  PubMed  Google Scholar 

  38. Neal JM, Brull R, Chan VWS, et al. The ASRA evidence-based medicine assessment of ultrasound-guided regional anesthesia and pain medicine. Executive summary. Reg Anesth Pain Med. 2010;35:S1–9.

    Article  PubMed  Google Scholar 

  39. Singelyn FJ, Lhotel L, Fabre B. Pain relief after arthroscopic shoulder surgery: a comparison of intraarticular analgesia, suprascapular nerve block, and interscalene brachial plexus block. Anesth Analg. 2004;99:589–92.

    Article  PubMed  Google Scholar 

  40. Hayek SM, Ritchey RM, Sessler D, et al. Continuous femoral nerve analgesia after unilateral total knee arthroplasty: stimulating versus nonstimulating catheters. Anesth Analg. 2006;103:1565–70.

    Article  PubMed  Google Scholar 

  41. White PF, Kehlet H, Neal JM, et al. The role of the anesthesiologist in fast-track surgery: from multimodal analgesia to perioperative medical care. Anesth Analg. 2007;104:1380–96.

    Article  PubMed  Google Scholar 

  42. Bernards CM, Hadzic A, Suresh S, et al. Regional anesthesia in anesthetized of heavily sedated patients. Reg Anesth Pain Med. 2008;33:449–60.

    PubMed  CAS  Google Scholar 

  43. Gerancher JC, Viscusi ER, Liguori GA, et al. Development of a standardized peripheral nerve block procedure note form. Reg Anesth Pain Med. 2005;30:67–71.

    PubMed  CAS  Google Scholar 

  44. Viscusi ER, Gerancher JC, Weller R, et al. Not documented? Not done! A proposed procedure note for neuraxial blockade. American Society of Regional Anesthesia and Pain Medicine 30th Annual Spring Meeting and Workshops. Abstract 68, April 21–24, 2005.

    Google Scholar 

  45. Coley KC, Williams BA, DaPos SV, et al. Retrospective evaluation of unanticipated admissions and readmissions after same day surgery and associated costs. J Clin Anesth. 2002;14:349–53.

    Article  PubMed  Google Scholar 

  46. O’Donnell BD, Iohom G. REgional anesthesia techniques for ambulatory orthopedic surgery. Curr Opin Anaesthesiol. 2008;21:723–8.

    Article  PubMed  Google Scholar 

  47. Rawal N. Organization, function, and implementation of acute pain service. Anesthesiol Clin N Am. 2005;23:211–25.

    Article  Google Scholar 

  48. Vila H, Smith RA, Augustyniak MJ, et al. The efficacy and safety of pain management before and after implementation of hospital-wide pain management standards. Anesth Analg. 2005;101:474–80.

    Article  PubMed  Google Scholar 

  49. Committee on Performance and Outcomes Measurement (CPOM), Committee on Quality Management and Departmental Administration (QMDA): Quality Management Template, http://www.asahq.org/quality/qmtemplate013105.pdf.2004.

  50. Katz RI, Lagasse RS. Factors influencing the reporting of adverse perioperative outcomes to a quality management program. Anesth Analg. 2000;90:344–50.

    PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, Huntington Hospital, Hofstra University School of Medicine in partnership with North Shore-LIJ Health System, 270 Park Avenue, Huntington, NY, 11743, USA

    Joseph Marino MD

  2. Billings Clinic Hospital, Billings, MT, USA

    Brian E. Harrington MD

Authors
  1. Joseph Marino MD
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  2. Brian E. Harrington MD
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Corresponding author

Correspondence to Joseph Marino MD .

Editor information

Editors and Affiliations

  1. University Hosp and Ochsner Kenner Hosp, Prof and Chairman,Dept of Anesthesiology, Director of Interventional Pain Mgmt., Louisiana State University School of Medicine, New Orleans, 70112, USA

    Alan David Kaye

  2. Harvard Medical School, Director, Proced Sedation Mgmt & Safety, Assistant Professor of Anesthesia, Anesthesiology, Perioperative & Pain Med, Boston, 02115, USA

    Richard D. Urman

  3. Yale University School of Medicine, Associate Professor of Anesthesiology, New Haven, 06520, Connecticut, USA

    Nalini Vadivelu

Appendices

Appendix 1: Lipid Rescue Algorithm

Appendix 2: Pain Management Log Book

Appendix 3: Pain Management Order Sheet

Appendix 4: Pain Management Order Sheet

Appendix 5: Pain Management Order Sheet

Appendix 6: Nursing Assessment Flow Sheet

Appendix 7: Patient Instruction Sheet for Outpatients Receiving Regional Blocks

Appendix 8: Post-op Multimodal Pain Management Orders

Appendix 9: Anesthesiology Postoperative Pain Management Procedure Record

Appendix 10: Outpatient Postoperative Contact Form

Appendix 11: Peel-and-Stick Form

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Marino, J., Harrington, B.E. (2012). Regional Anesthesia in the Community Practice Setting. In: Kaye, A., Urman, R., Vadivelu, N. (eds) Essentials of Regional Anesthesia. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1013-3_3

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  • DOI: https://doi.org/10.1007/978-1-4614-1013-3_3

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-1012-6

  • Online ISBN: 978-1-4614-1013-3

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