title: Anesthesia-controlled time and turnover time for ambulatory upper extremity surgery performed with regional versus general anesthesia.
abstract: OBJECTIVE
  To test the hypothesis that regional anesthesia (RA) employing a block room reduces anesthesia-controlled time for ambulatory upper extremity surgery compared with general anesthesia (GA).
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Outpatient surgery center of a university hospital.
  
  
  METHODS
  229 adult patients who underwent ambulatory upper extremity surgery over one year.
  
  
  METHODS
  Upper extremity surgery was performed with three different anesthetic techniques: 1) GA, 2) nerve block (NB) performed preoperatively, or 3) local anesthetic (LA), either Bier block or local anesthetic, administered in the operating room (OR).
  
  
  METHODS
  Demographic data, anesthesia-controlled time, and turnover time were recorded. Since the data were not normally distributed, differences in anesthesia-controlled time and turnover time were analyzed using the Kruskal-Wallis test and post-hoc testing using one-way analysis of variance on the ranks of the observations, with Tukey-Kramer correction for multiple comparisons.
  
  
  RESULTS
  Anesthesia-controlled time for NB (median 28 min) was significantly shorter than for GA (median 32 min, P = 0.0392). Anesthesia-controlled time for patients who received LA (median 25 min) was also significantly shorter than GA (P < 0.0001). However, turnover time did not differ significantly among the three groups.
  
  
  CONCLUSIONS
  Peripheral nerve block performed preoperatively in an induction area or LA injected in the OR significantly reduces anesthesia-controlled time for ambulatory upper extremity surgery compared with GA. Turnover time is unaffected by anesthetic technique. These results may increase acceptance of RA in the ambulatory surgery setting.
authors.affiliation: Department of Anesthesia, University of California, San Diego Medical Center, San Diego, CA 92103-8770, USA. ermariano@ucsd.edu
authors.forename: Edward R
authors.initials: ER
authors.lastname: Mariano
authors.forename: Larry F
authors.initials: LF
authors.lastname: Chu
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Peinado
authors.forename: William J
authors.initials: WJ
authors.lastname: Mazzei
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000765:Anesthesia, Conduction / Q000379:methods*; D000768:Anesthesia, General / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D009873:Operating Rooms / Q000458:organization & administration; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D034941:Upper Extremity / Q000601:surgery
chemical_list: D000779:Anesthetics, Local