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Abstract
Background and Aims This audit set out to investigate the outcomes of 35 block bay patients who had surgery purely under Regional Anaesthesia (RA), compared to 23 patients undergoing the same surgery with only general anaesthesia (GA) and no RA. AIMS Length of hospital stay, Same day discharge, Post Operative Pain Scores, Opioid requirements, Post Operative Nausea and Vomiting
Methods A retrospective observational study was performed over 6 months on upper limb surgery done under only GA or Regional. Data from admission to discharge was collected. Excluded: Children Ring blocks Combined GA and RA
Results Most patients stayed overnight due to surgical reasons, however, overnight stay due to anaesthetic reasons was significantly less with RA vs GA (9% vs 17%). Average post op pain after GA was 3.2 vs 0 with RA, with GA patients requiring on average 9.9mg of morphine before leaving the recovery unit. 8.5% of GA patients developed PONV, compared to none after RA.
Overnight stay due to Anaesthetic causes
Average post operative Pain
Conclusions The incidence of same day discharge after upper limb orthopaedic surgery in UHW remains impressively high regardless of anaesthetic modality in patients who do not have surgical indications to stay overnight, however, incidence of overnight stay due to anaesthetic complications alone is significantly lower after RA alone compared to GA (9% vs 17%). Secondary outcomes measured showed a significant benefit to RA vs GA in all categories. It was found that a majority of ASA 3 patients received RA, thereby avoiding the risks of GA. The Block Bay hereby demonstrates a clear cost saving and service delivery improvement.