PT  - JOURNAL ARTICLE
AU  - Victor Polshin
AU  - Julie Petro
AU  - Luca J Wachtendorf
AU  - Maximilian Hammer
AU  - Thomas Simopoulos
AU  - Matthias Eikermann
AU  - Peter Santer
TI  - Effect of peripheral nerve blocks on postanesthesia care unit length of stay in patients undergoing ambulatory surgery: a retrospective cohort study
AID  - 10.1136/rapm-2020-102231
DP  - 2021 Mar 01
TA  - Regional Anesthesia &amp;amp; Pain Medicine
PG  - 233--239
VI  - 46
IP  - 3
4099  - http://rapm.bmj.com/content/46/3/233.short
4100  - http://rapm.bmj.com/content/46/3/233.full
SO  - Reg Anesth Pain Med2021 Mar 01; 46
AB  - Background Peripheral regional anesthesia and analgesia may increase the efficiency of ambulatory surgical centers by reducing pain and preventing nausea and vomiting, which are important modifiable causes of prolonged postanesthesia care unit (PACU) length of stay. We hypothesized that the use of peripheral nerve blocks (PNB) was associated with shorter PACU length of stay in ambulatory surgery.Methods In this retrospective cohort study, we analyzed data from adult ambulatory surgical cases, in which PNB was a viable anesthetic option (ie, was routinely performed for these procedures), at an academic medical center between 2008 and 2018. We assessed the association between the use of PNB and the primary endpoint of PACU length of stay. As key secondary endpoint, we compared intraoperative opioid doses. Analyses were adjusted for patient demographics, comorbidities and intraoperative factors.Results A total of 57 040 cases were analyzed, of whom 13 648 (23.9%) received a PNB. The use of PNB was associated with shorter PACU length of stay (a decrease of 7.3 min, 95% CI 6.1 to 8.6, p&amp;lt;0.001). This association was most pronounced in surgeries of long duration (decrease of 11.2 min, 95% CI 9.0 to 13.4) and in patients undergoing leg and ankle procedures (decrease of 15.1 min, 95% CI 5.5 to 24.6). Intraoperative opioid doses were significantly lower in patients receiving a nerve block (decrease of 9.40 mg oral morphine equivalents, 95% CI 8.34 to 10.46, p&amp;lt;0.001).Conclusion The use of PNB significantly reduced PACU length of stay in ambulatory surgical patients, which may in part be attributed to lower intraoperative opioid requirements.