In order to encourage the use of regional, Gary Friedman, MD, vice
president of Nashua (N.H.) Anesthesia Partners, recommends includ-
ing it in surgical pathways through a multi-disciplinary protocol for
anesthesia, surgery and administration, namely "developing programs
that all stake-holders agree to and effectively integrate into their care
plans and management."
Dr. Friedman admits that this can be a big challenge and demands
major cooperation. But cooperative education and effort are critical
factors in making regional anesthesia work at your facility, since
administering effective blocks, as with the delivery of most aspects of
perioperative care, requires participation from more than just one play-
er.
"Most failures occur because of system problems, providers and
patients at all levels not being 'on the same page,'" notes Carrie L.
Frederick, MD, director of anesthesia services for the Plastic Surgery
Center in Portland, Maine. "Everyone needs to be educated about the
process, and understand their roles in it."
Selling regional to surgeons
"Undoubtedly, our surgical colleagues need to be on board and help
us lead these initiatives in order to have a comprehensive regional
anesthesia program," says Dr. Friedman.
But there's a problem. The perception among many surgeons is that
nerve blocks take too much time to set up. That they prolong case
turnovers and delay start times. That, no matter what benefits they
contribute to the patient experience, they're not absolutely necessary
in order to achieve the targeted operative outcomes, when general
anesthesia works fine. For many surgeons, regional administration
time is wasted time.
"The biggest obstacle for regional anesthesia is a lack of knowledge
8 2
O U T P A T 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 2 0 1 5
