ten reasons i love doing regional anesthesia
Poor pain control is a major concern for patients after surgery. Fortunately several potent methods exist for reducing pain including regional anesthesia. The use of local anesthetics (such as bupivacaine) to provide “regional block” of painful areas has been an important method of pain control ever since the discovery of the anesthetic effect of cocaine over 100 years ago. I use a lot of regional anesthesia to facilitate pain control for my patients.
Here are my top ten reasons why I love to use regional anesthesia:
1. Great pain control: Regional anesthesia has been shown in countless research studies to be superior to other methods for pain control after several types of surgery. Patients with good pain control feel better, sleep better and recover faster after surgery.
2. Less side effects: better pain control provided locally reduces the amount of other drugs (such as morphine) required and hence reduces nausea, dizziness, bowel and other problems after surgery.
3. Exciting research: Much research in the last twenty years has reinforced the benefit of regional anesthesia for early discharge and reduction in pain and side effects compared to general anesthesia. Newer findings suggest that patients who have regional anesthesia for certain types of surgery have fewer serious complications compared to general anesthesia such as intensive care admission and infections. These newer findings need confirmation in more rigorous studies however.
4. Great history: the field of regional anesthesia is only 100 years old yet abounds with fascinating characters such as Carl Koller who discovered cocaine, William Halstead, one of the great surgical pioneers and Gaston Labat, who formed the American Society of Regional Anesthesia.
5. Great teaching: from the first days of my anesthesia training the colleagues who taught me regional anesthesia always did so with an infectious enthusiasm. In turn I have tried to carry that on in my own practice to the benefit of my students and their patients.
6. Satisfaction: for an anesthetist there is nothing more satisfying then caring for a patient through a difficult surgical procedure and leaving them comfortable and able to rehabilitate quickly in the hours, days (and sometimes) weeks after surgery. Regional anesthesia techniques greatly facilitate our ability to do this especially for certain types of surgery.
7. Environmentally friendly and cheap: use of local anesthetics do not have any of the ozone depleting effects of the inhalational anesthetic agents. In addition local anesthetic drugs are relatively inexpensive, requiring less equipment to administer and of great potential benefit in lower resource environments.
8. Great people: several medical societies around the world promote the use of regional anesthesia through education, funding of high quality research and providing a forum for exchange of ideas. The American Society of Regional Anesthesia, first formed in 1923, is one such society where like-minded colleagues share ideas and teach each other at their twice yearly meeting. Several other societies around the world perform a similar function including the recently formed African Society of Regional Anesthesia.
9. Technically demanding: for many anesthetists the ability to perform a technically demanding procedure and provide a superior outcome for their patient gives great satisfaction. Our training programs have made great strides in the last twenty years to disseminate the skills required to perform safe and effective regional anesthesia but recent advances such as use of ultrasound require further study to determine best teaching methods.
Pain and ultrasound: guiding the hurt away
10. Common goals: in the last twenty years I have met hundreds of colleagues from all parts of the world who share the same goal: to provide the best care for our patients through the use of regional anesthesia. I have met and gained many friendships with like-minded people and realized through our common passion for best patient care that it is a very small world in which we live. All through the use of regional anesthesia.
For those of you who want further information on management of pain after surgery and the benefits of regional anesthesia please check out the following resources from the American Society of Regional Anesthesia and from the The Ottawa Hospital.