Outpatient Surgery Magazine - Subscribers

Not the Retiring Type - January 2015 - 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 25 of 148

2 6 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 | J A N U A R Y 2 0 1 5 A dminister a nerve block to a patient under gen- eral anesthesia? Not a safe practice, say 89.8% of the 106 anesthesia providers we polled, unlike the Wisconsin anesthesiologist embroiled in a deadly malpractice trial (tinyurl.com/lyk2xn3) who says he prefers to give blocks to uncon- scious patients because they don't flinch when he inserts the needle. That may be true, but a lawsuit claims a man, 62, suffered a fatal heart attack shortly after being administered an interscalene nerve block while still under general anesthesia during rotator cuff surgery. Because he was unconscious, the suit says, he was unable to report the classic symptoms of an intravascular injection — ringing in the ears, numbness and tingling around the mouth. The patient's widow argued that her husband should have been given the option to remain awake while the block was being done. The trial against anesthesiologist Robert Corish, MD, was still ongoing at the time of publication, but some anesthetists offered their own verdicts. "If one needs a patient to be under general anesthesia to do a brachial plexus block, perhaps they should find a more talented provider for that task," says Gregory Rendelman, CRNA, of the Lebanon (Pa.) VA Medical Center. In court, Dr. Corish insisted that he isn't alone — that the practice is the standard of care for many of his colleagues. Yet only 2% of our survey respondents prefer that patients be unconscious; another 8% S U R G E O N S ' L O U N G E Nerve Blocks on Unconscious Patients a Bad Idea aWakE anD aWaRE z Still reSPOnSiVe It's important, say providers, for patients to be able to answer questions while being blocked.

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