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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6 2 O U T P AT 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 | M A R C H 2 0 1 4 2. Create a block team We have 2 anesthesiolo- gists and a regional anes- thesia fellow, who alone placed 1,553 blocks of the more than 3,200 our team placed last year. Together, we place between 30 and 35 on a busy day. Block nurses are critical to our high-volume success. We're fortu- nate our facility's administrator realized early on that dedicating mem- bers of the pre-op nursing staff to our regional program would improve its overall efficiency. Anesthesia providers are often pulled in multiple directions on the day of surgery and can be easily distracted from placing blocks on time. So each anesthesiologist here is assigned a block nurse who helps him stay on track and perform all his blocks. The nurses ensure the ultrasound units, needle trays, local anesthetics and pain pumps are set up and ready to go as soon we arrive in pre-op to place the blocks, which saves us 15 to 20 minutes between cases and keeps the program from grinding to a halt. 3. Invest in ultrasound It's hard to call ultrasound imaging the standard of care in block placement, because that phrase carries a lot of weight in clinical cir- cles, but the technology is critical to regional's success. Placing consistently effective blocks is challenging, which is a draw- back that prevents some anesthesia providers from adding the tech- nique to their pain control repertoire. Ultrasound eliminates that vari- R E G I O N A L B L O C K S EXPAREL ® (bupivacaine liposome injectable suspension) is promoted as providing pain control that lasts for up to 72 hours without the need for catheters and pumps. 1 In fact, their two pivotal studies tell a different story. 2-4 We feel it is important that you know the facts. A K I M B E R L Y - C L A R K H E A L T H C A R E C O M P A N Y FACT VS FICTION Every day without costs you more 5 • Using limited studies and cumulative data, EXPAREL ® claims that a single injection can provide up to three days of "patient-focused pain control." 1 Yet, in a pivotal bunionectomy study, it is no more effective than a placebo beyond 12 hours. 3 • EXPAREL ® is not titratable. 5 – Cannot control fl ow rate – Cannot turn on or off as needed • In a pivotal study, after 12 hours there was no attendant decrease in morphine consumption. 4 ON-Q* has demonstrated effectiveness across multiple procedures in over 150 studies. We have provided over 3.5 million patients with effective, safe, personalized pain relief for up to fi ve days, not just 24 hours. 6 ON-Q* Proven. Controllable. Long-lasting. 6 Contact your ON-Q* representative for more information. EXPAREL's studies only demonstrate 12 hours of pain relief. 3-4 KEY PLAYERS Block nurses prepare needed supplies and ready the ultrasound unit to keep regional programs on track. Emily DeBusk, RN OSE_1403_part2_Layout 1 3/5/14 10:52 AM Page 62