Page 8
P A I N
C O N T R O L
administered as a single injection into the nerve sheath or with a catheter threaded into place near the targeted joint to deliver an anesthetic continually or intermittently. An intravenous regional block (called a Bier block) involves injecting medications directly into a vein of the arm while using a tourniquet on the affected limbs. For all these methods, patients can typically feel touch and pressure, but not pain.
Regional blocks can extend pain control beyond the OR.
Patients who receive regional blocks instead of general anesthesia before foot surgery can be sent home and not require pain medication for 48 to 72 hours. Pain is also controlled without narcotics, allowing for faster discharges and more comfortable convalescing at home. Additionally, patients who receive regional blocks
require less airway manage-
PROVEN RESULTS
Regional Lowers Complication Risks
Neuraxial blocks dramatically improve the surgical outcomes of patients undergoing hip or knee arthroplasty, according to a study in the May 2013 issue of the journal Anesthesiology (tinyurl.com/mpvmt2t).
Researchers at Cornell University's Weil Medical College in Ithaca, N.Y., reviewed the records of approximately 382,000 patients who underwent total hip or knee procedures between 2006 and 2010 at hospitals nationwide. Of the group, 11% percent received neuraxial blocks, 14% received a combination of neuraxial blocks and general anesthesia and 75% received only general anesthesia.
They discovered neuraxial blocks lowered 30-day mortality rates by 80%, risk of prolonged hospital stays by 30% and major complication risks by 30% to 50%. "While anesthesia is commonly viewed as a tool to allow surgery to safely take place," says study lead author Stavros George Memtsoudis, MD, PhD, "the type of anesthesia used may have a far bigger impact on patients' outcomes than previously assumed."
— Daniel Cook
