TITLE:
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)
AUTHORS:
Dennis E. Feierman, Eliezer Klinkowitz, Charles Keilin, Mark Kronenfeld, David Rahmani, Darlene Saberito, Piyush Gupta
KEYWORDS:
Ambulatory, Nerve Block, PACU, Length of Stay
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.5 No.7,
July
27,
2015
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.