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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factors. An incorrect amount of anesthetic agent or an improperly placed injection can deliver a less-than-effective attempt. Morbid obe- sity and anatomical variations can make it difficult to accurately locate nerve structures. "If we are aware of the block failure before the surgical procedure, the surgeon will sometimes supplement it with local anesthetic," says Ms. Wenzel of Kenwood Surgery Center. "Anesthesia will sometimes re- block the patient in the post-op area." But even the existence of a "Plan B" can slow the efficiency that regional techniques are intended to bring. What can prevent block failure? In a word, ultrasound. Equipping your providers with the technology gives them the ability to visualize neural anatomy and deliver an effective amount of anesthetic directly to the targeted site for a high block success rate. "Ultrasound guid- ance makes the blocks safer and faster, and allows us to completely surround the nerve bundles, ensuring a dense and long-lasting block," says Mr. Long. Whether used in conjunction with electrical nerve stimulation for 8 7 O C T O B E R 2 0 1 5 | O U T P A T I E N TS U R G E R Y. N E T Total joint replacement has a reputation for being one of the most painful surgeries to recover from. If you're hosting it as an outpatient procedure, as an increasing number of facilities are, your pain management plan had better be bulletproof. According to a recent Outpatient Surgery Magazine Instapoll, 62% of facilities that perform same-day hips and knees rely on regional anesthesia to keep post-op pain under control. For more on outpatient total joints, please see "3 Key Debates in Same-Day Knee Replacement" on page 94. O utpatient knee replacement is one of surgery's hottest trends, but questions persist about how to best prepare patients for same-day discharge. Is robotics necessary? Do you really need to work with vendor reps? Is regional anesthesia a better option than inhalational? Whether you're thinking about adding outpa- tient knees or you already host the procedures, read on to find out what experts say about those key considerations. 9 4 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 C T O B E R 2 0 1 5 3 Key Debates in Same-Day Knee Replacement Daniel Cook Executive Editor Experts discuss the roles of robotics, vendor reps and anesthesia in the outpatient evolution. ❚ JOINT EFFORT Knee replacements can be done in outpatient facilities with a perfectly executed multidisciplinary team approach. Mount Carmel Health System SAME-DAY HIPS & KNEES Blocks for Total Joints Provide Bulletproof Pain Control