Regional Anesthesia

Introduction
The management of postoperative pain in the ambulatory surgical setting can be challenging. The use of regional anesthetic techniques, along with multimodal systemic analgesics and pain risk stratification, can be of significant benefit in postoperative analgesia.

Our goal at SAMBA is to provide our members with concise, up-to-date, and evidence-based information that can be of help with regional anesthesia education and clinical decision-making. Please keep in mind that responsibility for all regional anesthetic techniques and clinical decisions ultimately rests with the clinician.

Regarding regional anesthetic techniques, many members have found in-person training to be most beneficial. If you would like to practice hands-on scanning for “must-know” blocks, we encourage you to attend the ultrasound workshops at our annual SAMBA meeting.

The Use Of Pectoralis Blocks In Breast Surgery: A Practice Advisory From The Society For Ambulatory Anesthesia (SAMBA)

Alberto Ardon MD, et. al.

More institutions are utilizing pectoralis blocks for breast surgery. This could lead to a reduction in PACU opioid consumption and decrease postoperative pain scores when compared to systemic analgesics. PECs blocks seem to be equal in comparison to a single-shot paravertebral injection regarding postoperative opioid requirements and time to rescue analgesia. Although further investigation is necessary, these blocks could be an extremely useful tool in the ambulatory setting.

Acute and Chronic Pain in the Ambulatory Setting

Ultrasound-Guided Regional Anesthesia

The Basics of Ultrasound
New to ultrasound? Check out these resources to help you get acquainted with the basics! 

Anticoagulants and Regional Anesthesia

For neuraxial techniques, deep plexus blocks, and peripheral nerve blocks at non-compressible sites, it is useful and necessary to be familiar with the most recent recommendations regarding anticoagulation. While use of an epidural catheter may be uncommon in ambulatory anesthesia, spinal anesthetics may be beneficial in certain surgeries and in patients with certain comorbidities.

The following is a guideline based on the most recent recommendations of the American Society of Regional Anesthesia (ASRA) and European Society of Regional Anesthesia (ESRA). While intended as a quick-reference, please also refer to the most recent electronic recommendations from these societies as needed.

Common (and not-so-common) Troubleshooting Issues

What do you do when a patient calls back complaining of a leaking nerve catheter? When do they need to come back for the surgical center for an in-person evaluation?

Fear not, the following tip sheet may be of use.

Upper Extremity Peripheral Nerve Blocks – What you need to know

Lower Extremity Peripheral Nerve Blocks – What you need to know

Nerve Block Videos

Webinar Videos

Bibliographies