Chapter 50. Peripheral Nerve Blocks for Outpatient Surgery
With the use of regional anesthesia, what should be the first priority?
C. Minimizing opioid and general anesthesia side effects
A is correct. With the use of regional anesthesia techniques, the first priority should be on safety.
B, C, and D are incorrect. The second priority should be reducing patient pain and minimizing opioid and general anesthesia (GA) side effects. The third priority should be economics, and the fourth efficiency.2,3
For what reason is multimodal analgesia important in ambulatory surgery?
B. Prolonging hospital stay
C. Additive positive effects
A is correct. Well-planned multimodal analgesia is important in the ambulatory surgery setting for several reasons. First, patients prefer to avoid side effects such as nausea, vomiting, and somnolence.4,5
B is incorrect. Uncontrolled side effects can result in unplanned hospital admission, which is costly and inconvenient for all parties.
C is incorrect. The use of multimodal analgesia has the potential for real synergistic positive effects while also reducing the likelihood of serious side effects.6
D is incorrect. Multimodal analgesic regimens improve the likelihood of early recovery.7
Concerning multimodal analgesia, which statement is true?1
A. High-dose opioids are a cornerstone in the multimodal treatment strategy.
B. Locoregional anesthesia is a cornerstone in the multimodal treatment strategy.
C. The use of locoregional anesthesia will not reduce the postoperative need for opioids.
D. Locoregional anesthesia is not a part of the multimodal treatment strategy.
B is correct. In an outpatient setting, regional anesthesia with peripheral nerve blocks (PNBs) is a cornerstone of multimodal analgesia and opioid-sparing strategies.
A is incorrect. High-dose opioids can cause hyperalgesia by activating neurons and glial cells.8
C is incorrect. Potent opioids, such as remifentanil and fentanyl, can cause hyperalgesia and rapid tolerance in humans.9 Other undesirable side effects are nausea, somnolence, and respiratory depression, all of which are highly undesirable in the outpatient setting.
D is incorrect. In an outpatient setting, regional anesthesia with peripheral nerve blocks (PNBs) is a ...