Chart Review of PACU Outcomes for Patients Who Had Ambulatory Shoulder Surgery with Peripheral Nerve Block (PNB) and General Anesthesia Compared to General Anesthesia (GA)

DOI: 10.4236/ojanes.2015.57031   PDF   HTML   XML   3,788 Downloads   4,284 Views   Citations

Abstract

Introduction: Today, regional anesthetics are frequently used in combination with general anesthesia. The purpose of two different techniques is to attain distinct goals. We believed that the use of PNB with the minimization of GA in the ambulatory setting would result in a decreased opioid requirement and subsequently fewer treatment-related side effects, more awake and pain free patients and shorter PACU stays and earlier discharges when compared with general anesthesia alone. Methods: Prior to the start of this retrospective chart review, IRB approval was obtained. Patient’s charts were selected based on the following criteria: The control group had a general anesthetic (GA) and did not have a PNB, and the experimental group (PNB/GA) had a PNB and a general anesthetic. Our primary endpoints were PACU length of stay, pain scores, use of opioids and uses of anti-emetics. Results: We found that patient with blocks used less analgesic in the PACU, 3.97 mg vs. 1.39 mg (morphine equivalents). They also appeared to use less antiemetic drugs: 14/19 (patient s without PNB) vs. 7/18. Additionally, the patients that received a block had a statistically shorter PACU stay 107 min vs. 163 min. Conclusion: Patients that did not receive PNB had a significantly longer PACU stay. Additionally the data suggest that the use of PNB’s reduces the use of post-op narcotics, which may be related to the lower use of postoperative antiemetic drugs observed.

Share and Cite:

Feierman, D. , Klinkowitz, E. , Keilin, C. , Kronenfeld, M. , Rahmani, D. , Saberito, D. and Gupta, P. (2015) Chart Review of PACU Outcomes for Patients Who Had Ambulatory Shoulder Surgery with Peripheral Nerve Block (PNB) and General Anesthesia Compared to General Anesthesia (GA). Open Journal of Anesthesiology, 5, 173-176. doi: 10.4236/ojanes.2015.57031.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Klein, S.M., Evans, H., Nielsen, K.C., Tucker, M.S., Warner, D.S. and Steele, S.M. (2005) Peripheral Nerve Block Techniques for Ambulatory Surgery. Anesthesia and Analgesia, 101, 1663-1676.
http://dx.doi.org/10.1213/01.ANE.0000184187.02887.24
[2] Dexter, F. and Macario, A. (2000) What Is the Relative Frequency of Uncommon Ambulatory Surgery Procedures Performed in the United States with an Anesthesia Provider? Anesthesia and Analgesia, 90, 1343-1347.
http://dx.doi.org/10.1097/00000539-200006000-00015
[3] Hadzic, A., Williams, B.A., Karaca, P.E., Hobeika, P., Unis, G., Dermksian, J., Yufa, M., Thys, D.M. and Santos, A.C. (2005) For Outpatient Rotator Cuff Surgery, Nerve Block Anesthesia Provides Superior Same-Day Recovery over General Anesthesia. Anesthesiology, 102, 1001-1007.
http://dx.doi.org/10.1097/00000542-200505000-00020
[4] Lanz, E., Theiss, D. and Jankovic, D. (1983) The Extent of Blockade Following Various Techniques of Brachial Plexus Block. Anesthesia and Analgesia, 62, 55-58.
http://dx.doi.org/10.1213/00000539-198301000-00009
[5] Ilfeld, B.M., Morey, T.E. and Enneking, F.K. (2002) Continuous Infraclavicular Brachial Plexus Block for Postoperative Pain Control at Home: A Randomized, Double-Blinded, Placebo-Controlled Study. Anesthesiology, 96, 1297-1304.
http://dx.doi.org/10.1097/00000542-200206000-00006

  
comments powered by Disqus

Copyright © 2020 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.