Outpatient Surgery Magazine - Subscribers

No More Empty Beds - Outpatient Surgery Magazine - February 2020

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://magazine.outpatientsurgery.net/i/1208631

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Page 36 of 114

settings, nerve blocks are used in a mere 3% of surgeries that are eli- gible for them. Even during shoulder arthroscopies — obvious can- didates for regional anesthesia — blocks are used only 41% of the time, giving patients a less-than-a-coin-flip chance of getting one. If only a small number of anesthesia practitioners are using basic blocks, even fewer understand and perform the newer novel blocks that have emerged. The advent of these often more complicated blocks can easily intimidate some practitioners and convince them to avoid using regional anesthesia at all. This "complexity bias" has widened the gap between pioneers in the field and anesthesia generalists, and patient care may suffer in the long run. While the pursuit of new techniques is always a worthy one, I also think there needs to be a movement toward getting the most out of the current blocks we have (see "5 Blocks Every Provider Should Know"). A back-to-basics approach — offering a basic blocks package and standardizing how they are taught and implemented — would bridge the gap between academic experts in the field and practi- tioners who are in the trenches every day. It would also go a long way toward providing patients with more consistent and reliable opioid-sparing pain-relief. Gradual change Making competency in even a basic set of blocks the norm won't hap- pen overnight. Training must evolve. Currently, an anesthesiology resi- dent must have provided care to 40 peripheral nerve block patients in order to graduate. There's no breakdown, however, on which nerve blocks must be performed or how many times they're used. So, a resi- dent can theoretically meet the requirement by administering 40 dif- ferent nerve blocks one time each. For experienced anesthesia practi- F E B R U A R Y 2 0 2 0 • O U T PA T I E N T S U R G E R Y. N E T • 3 7

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