Regional anesthesia for outpatient surgery: possibilities and risks

Regional anaesthesia (RA) in the ambulatory setting presents both opportunities and risks, especially in an economically challenging healthcare system. Patients tend to associate RA with the risk of neuronal damage, paralysis and the need to be awake during surgery. However, the risks beyond the rare complications and associated claims are more likely to be variable neuronal blockade effects and disadvantages in high-throughput OR management. The use of RA techniques in the outpatient setting requires experienced selection of suitable patients, consideration of pre-existing risks such as coagulopathies, rapid standard set-up procedures, ultrasound guidance to avoid vascular and nerve damage and good psychological counselling of patients. A clinic with many outpatient procedures can become even more efficient through higher throughput, pain-free and awake procedures without patient discomfort. RA also offers significantly safer approaches for high-risk patients. Based on the experience of a university outpatient clinic, this short review discusses the use of RA with its risks and opportunities.