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Partners of Naperville, Ill.
However, regional's post-op analgesic effects lower pain scores,
which decreases the need for opioids, which cuts the risk of grogginess,
nausea, vomiting, delirium, respiratory depression or other recovery-
prolonging side effects, which speeds discharges. "For an outpatient
facility, any technique that avoids the use of opioids is advantageous,"
says Mark E. Hudson, MD, MBA, associate professor of anesthesia at
the University of Pittsburgh School of Medicine.
"Under regional, within minutes after surgery they're having 7-Up
and crackers. In 20 to 25 minutes they're dressed. In 30 minutes,
they're in a wheelchair, heading for the car," says Dr. Rosen. "Regional
changes the culture of recovery."
Specifically, it can let your patients skip Phase 1 PACU. "There's no
emergence time if a patient never has to wake up from anesthesia,"
says Eric Crabtree, MD, of Sheridan Healthcare, who directs anesthe-
sia services at the Sanford-Bemidji Medical Center in Bemidji, Minn.
"Going straight to Phase 2 recovery, that's several minutes of through-
put time saved there."
Rules for a modern process
In fact, recovery criteria should be updated to accommodate changes
in surgical anesthesia and facilitate accelerated discharges, says Brian
A. Williams, MD, MBA, director of acute pain medicine, regional anes-
thesia, ambulatory anesthesia and pre-operative evaluation at the VA
Pittsburgh HealthCare System. "Do what you can to jettison old crite-
ria that don't address the details of modern anesthesia use," he says.
For a 2011 article published in the journal Anesthesia Clinics, he
and a colleague developed the WAKE score, a patient-centered ambu-
latory anesthesia and fast-tracking outcomes criteria that monitors
respiration and oxygen saturation, among other factors, to replace the
A N E S T H E S I A
"
Our patients matter
most. By minimizing
post-op pain and
decreasing side e5ects,
we're improving the
patient experience
signi
