ous blocks stay in is based on anesthesiologists'
comfort level and institutional culture.
• Better imaging. Handheld ultrasound devices
don't replace larger ultrasound machines, but are
well suited for bread-and-butter blocks, as well as
for serving as a backup to your main unit. Some
handheld devices feature pixel electronics and
require different probes for different functions. Cost
can be a limiting factor, as the machine runs about
$60,000 and each probe costs roughly $15,000. Most
blocks, however, can be performed with a single lin-
ear probe. Other handheld devices use semi-con-
ductor technology instead of pixel electronics, work
very well and are a game-changer because of their
cost — only $2,000. The image isn't quite as good as
more expensive models, but is adequate for many
applications. Some models come with needle-identi-
fication technology that can help new practitioners
safely place a block or help with placement in a
patient with a large body habitus.
Untapped potential
One reason nerve blocks aren't used as often as
they should be is many experienced anesthesia
providers were trained to use nerve stimulation
blocks and don't see the advantage of using
ultrasound. Lack of training in regional anesthe-
sia will result in inconsistent outcomes —and
surgeons don't like inconsistencies. Some anes-
thesia providers think they can perform nerve
blocks without additional training or after taking
the equivalent of a weekend course, which isn't
the case.
The first step toward incorporating or increasing
the use of nerve blocks in your facility is to hire a
provider with experience in administering regional
anesthesia with the intention of teaching the rest of
the anesthesia team how to do it. Investing in some-
one who performs successful blocks all the time is
the best way to safely transition to performing more
blocks and achieve more consistent results.
5 8 • O U T P A T I
E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 2 0
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