A Comparative Study of General Anesthesia, Intravenous Regional Anesthesia, and Axillary Block for Outpatient Hand Surgery: Clinical Outcome and Cost Analysis

Abstract

IV regional anesthesia can offer a more favorable patient recovery profile and shorter postoperative nursing care time and hospital discharge time than an isoflurane-based general anesthetic or brachial plexus block technique for hand surgery.

Peripheral nerve blocks give greater hemodynamic stability than general anesthesia for ASA III patients undergoing outpatient knee arthroscopy

“…Regional anesthesia is reported to be associated with less nausea and vomiting, fewer unscheduled hospital admissions, shorter times in the operating room and in postoperative care as well as greater patient satisfaction with the anesthetic [7,8,18]. The groups in this study did not differ with regard to the occurrence rate of PONV, rate of unscheduled hospital admissions or patient satisfaction with the anesthetic.…”

“…General anesthesia is the most commonly used anesthetic technique [2], but orthopedic procedures can be performed using neuroaxial methods, such as spinal or epidural anesthesia [2,3] or with peripheral nerve blocks [3][4][5][6]. The studies showed that regional anesthesia gave shorter process times, greater patient satisfaction, lower rates of nausea and vomiting and a lower rate of unscheduled hospital admission than general anesthesia [7,8].…”

Pain Management Strategies in Hand Surgery

“…Similarly, Chan et al 13 prospectively examined three anesthetic techniques during hand procedures, namely general anesthesia (GA) and two regional anesthetic techniques, IV regional anesthesia (IVRA) and axillary brachial plexus block, with respect to clinical outcome, time efficiency, and hospital cost. He found that regional anesthesia is associated with a more favorable patient recovery profile than GA, requiring less nursing care in the PACU and an earlier hospital discharge.…”

A regional anesthesia-based “swing” operating room model reduces non-operative time in a mixed orthopedic inpatient/outpatient population

“…For example, in upper extremity surgery, use of brachial plexus blockade (BPB) rather than general anesthesia (GA) leads to reduced postoperative pain and analgesic requirements, [5][6][7][8][9][10][11][12][13] decreased postoperative nausea and vomiting (PONV), [5][6][7][8][9]13 and reduced length of stay in the postanesthesia care unit (PACU). [6][7][8][9][10][11][12][13][14] The recent introduction of ultrasound technology has led to an increased interest in regional anesthesia as its use is associated with numerous advantages, including the potential for accelerated onset times and greatly improved success rates.…”