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How Do You Measure Up? - October 2013 - Subscribe to Outpatient Surgery Magazine

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

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Page 65 of 118

OS_1310_part2_Layout 1 10/7/13 10:26 AM Page 66 R E G I O N A L A N E S T H E S I A Remember not to overfeed catheters, especially if you can't visualize and are not stimulating them. It makes no sense to perfectly position a needle next to a nerve (either by nerve stimulation or ultrasound) and then blindly thread your catheter 3 to 5cm beyond it. CPNB PLACEMENT Making the Case for Continuous Nerve Blocks ith a continuous nerve block, you can send a patient home and know he won't have pain for 2-3 days, getting him past the worst period for post-operative pain. "Regional anesthesia is the only way you can guarantee ongoing analgesia without the side effects of general anesthesia," says William F. Urmey, MD, associate attending anesthesiologist at the Ambulatory Surgery Center at the Hospital for Special Surgery in New York, N.Y. Other benefits include: 1. Patient satisfaction. Patient satisfaction is high for continuous blocks, says Jeffrey M. Richman, MD, director of regional anesthesia and acute pain at the University of Maryland St. Joseph's Medical Center in Towson, Md. Patients experience fewer side effects such as nausea and vomiting, sedation, constipation and pruritis, he says. Continuous nerve blocks are associated with minimal side effects and provide unlimited block duration at a distance from spinal and epidural areas so you don't have problems with the neuraxis, says Dr. Urmey. "If patients are taking anticoagulants, CPNBs let you avoid epidural hematomas. They have better sleep patterns post-operatively, less urinary retention and are up and about quicker and able to commence therapy." In his research, Dr. Richman has determined there is a 35 to 50% reduction in pain scores for patients with a CPNB as compared with those taking opioids. CPNB patients often receive a call from the anesthesiologist to check on their progress. "Anecdotally, I have seen this type of attention and care increase our reputation as a good place to go for surgery," says Dr. Richman. W 6 6 O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | O C T O B E R 2013

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