Anesthesia-controlled time and turnover time for ambulatory upper extremity surgery performed with regional versus general anesthesia.
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.
Mariano
Edward R
ER
Department of Anesthesia, University of California, San Diego Medical Center, San Diego, CA 92103-8770, USA. ermariano@ucsd.edu
Chu
Larry F
LF
Peinado
Christopher R
CR
Mazzei
William J
WJ
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
D000779:Anesthetics, Local