tle box that connects
to a wireless system
and downloads to the
electronic record
would monitor their
vital signs, blood pres-
sure and pulse oxime-
try all the way
through to discharge,"
he says. Besides not
having to connect and
reconnect the patient in pre-op, the OR and PACU, Dr. Papadakos
says you'll be able to medicate patients better if you're able to moni-
tor them on a continuum.
4. More peripheral nerve blocks
Would it shock you to learn that very few patients receive peripheral
nerve blocks (PNBs)? Of the 25% of outpatients who are amenable to
PNBs, only about 3.3% receive a block, according to research Rodney
Gabriel, MD, MAS, and colleagues recently published on the use of
regional anesthesia in the United States. It's hard to identify one reason
that outpatient centers across the country aren't using PNBs with more
frequency, but there could be several causes.
Many anesthesiologists simply aren't comfortable placing blocks
because they haven't been trained in modern techniques like ultrasound
guidance. Surgeons might frown on PNBs because of the time element
— it can take an extra 30 minutes to perform the procedure pre-opera-
tively, says Dr. Gabriel, chief of the division of regional anesthesia and
acute pain anesthesiology at University of California, San Diego. Plus,
they might have their own preferred techniques for pain control, includ-
5 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 1 8
• TARGET PRACTICE Some anesthesia providers may need training in order to
become adept at placing ultrasound-guided blocks.
