1 3 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 | F E B R U A R Y 2 0 1 5
To evaluate the efficacy of their facility's catheter program, Tariq M. Malik, MD, and Sehar S.
Gafoor, MD, conducted a 2-year retrospective analysis (tinyurl.com/ljvx95h) that turned
out to be less encouraging. Of 334 patients, 314 were satisfied with the pain control the
technique provided, but a total of 70 complications were reported, with 17 cases of pre-
mature removal of the catheter leading the way, followed by leakage (11), poor control (8)
and primary failure (6). Additionally, 100 patients had questions that weren't answered by
(or seen on) their written instructions, and 15 called the facility after hours.
There were also 4 cases of stuck catheters, 2 of which required skin exploration around
the insertion site, and one reported hematoma. The take home: "Continuous peripheral
nerve catheters provide a superior mode of analgesia," they say, "(but) our own experience
shows that managing a patient with CPNC at home requires much attention and care."
Patients Prefer Phone Calls
◗If you assume patients would prefer to take care of their pre-anesthesia evaluations (PAEs)
over the phone, rather than in person, you're right, and now there's data
(tinyurl.com/jwem7lj) to back up that assumption. The University of Texas Medical
Branch used to ask patients to come in for their PAEs. Then, came Hurricane Ike, in 2008,
and, in its wake, devastation that required the facility to temporarily switch to phone-based
information gathering. Not surprisingly, the question arose: Which did patients prefer?
The answer: An overwhelming majority (97%) of 75 surveyed patients said they preferred
the ease and convenience of taking care of the assessment over the phone, regardless of
how far they lived from the facility. The expressed preference was across the board, regard-
less of gender, age, type of surgery, type of anesthetic, admission status or education level.
Folks simply preferred the phone, even those few who were ultimately dissatisfied with
their anesthetic (primarily because of PONV).
Phone calls were also just as efficacious, say the researchers. None of the surveyed
patients had surgical delays or cancellations. OSM
A N E S T H E S I A A L E R T
Mr. Burger (jburger@outpatientsurgery.net) is an associate editor of Outpatient Surgery.
