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Flexibility
Nerve blocks are opioid-sparing and therefore decrease a multi-
tude of side effects associated with opioid use that can stall
post-op recoveries. Thanks to regional blocks, patients are able to meet
discharge criteria sooner. Despite the clear advantages of using regional
blocks, many facilities still hesitate to add a program. Barriers to imple-
mentation exist on several fronts — surgeons, nurses, anesthesia
providers and administrators might resist change and it's not an easy
status quo to break.
Surgeons might be the toughest to convince. Many have been taught
that blocks will ruin surgical efficiencies, delay case start times and
potentially decrease the amount of procedures they can do in a day.
That's a common misconception. Blocks might appear to delay the
start of cases, but the time used to place a block before surgery is
more than made up for on the back end through faster PACU recover-
ies. The overall efficiencies of the facility improve.
We make sure surgeons understand that their efficiencies remain a
top priority and that we're not placing blocks at the expense of their
operating room time. We make them understand that we're all pulling
in the same direction and striving toward a common goal.
Placing blocks before procedures in a dedicated area outside the OR
can help maintain perioperative efficiencies, but isn't essential to
ensuring cases start on time. In general, we try to perform blocks in
pre-op before procedures, but if the surgeon is significantly ahead of
schedule or if placing the block before the procedure will cause a sig-
nificant delay in the operating room, we won't hesitate to place a
recovery block. Some experts argue that patients should always
receive nerve blocks pre-operatively for the hypothetical benefit of
preemptive analgesia, but in reality a block placed immediately post-
operatively results in a similar patient experience. Some experts even
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