Division of Obstetric Anesthesia, Department of Anesthesiology, Saitama Medical Center, Kawagoe, Japan.
Anesthesiology and Pain Medicine, Sinai Health, Toronto, Ontario, Canada.
Reg Anesth Pain Med. 2021 Nov;46(11):986-991. doi: 10.1136/rapm-2021-102545. Epub 2021 May 12.
Regional anesthesia techniques offer many benefits for total joint arthroplasty (TJA) patients. However, they require personnel and equipment resources, as well as valuable operating room (OR) time. A block room offers a dedicated environment to perform regional anesthesia procedures while potentially offsetting costs.
The goal of this prospective quality improvement study was to develop a business case for implementation of a regional anesthesia block room and to demonstrate the cost-effectiveness of this program in decreasing OR time for TJA. All elective TJA patients presenting between January 2019 and March 2020 were included in our analysis.
Our detailed business plan was approved by the hospital leadership. 561 patients in the preintervention group and 432 in the postintervention group were included for data analysis. Mean total OR time per surgical case decreased from 166 to 143 min for a difference of 23 min (95% CI 17 to 29). Similarly, anesthesia controlled OR time decreased from 46 min to 26 min for a difference of 20 min (95% CI 17 to 22). The block room resulted in an additional primary TJA case per daily OR list. The percentage of TJA patients receiving a peripheral nerve block increased from 63.1% to 87.0% (p<0.001). No safety events or block room associated OR delays were observed.
Implementing a regional anesthesia block room required a comprehensive business plan for securing the necessary resources to support the program. The regional anesthesia block room is a cost-effective method to improve patient care and OR efficiency.
区域麻醉技术为全关节置换术（TJA）患者带来了诸多益处。然而，它们需要人员和设备资源，以及宝贵的手术室（OR）时间。阻滞室提供了一个专门的环境来进行区域麻醉程序，同时可能降低成本。
本前瞻性质量改进研究的目的是为实施区域麻醉阻滞室制定商业案例，并证明该计划在缩短 TJA 的 OR 时间方面具有成本效益。我们的分析纳入了 2019 年 1 月至 2020 年 3 月期间所有择期 TJA 患者。
我们详细的商业计划得到了医院领导层的批准。干预前组有 561 例患者，干预后组有 432 例患者纳入数据分析。每个手术病例的总 OR 时间平均从 166 分钟减少到 143 分钟，相差 23 分钟（95%CI 17 至 29）。同样，麻醉控制的 OR 时间从 46 分钟减少到 26 分钟，相差 20 分钟（95%CI 17 至 22）。阻滞室使每个每日 OR 列表增加了一个主要的 TJA 病例。接受外周神经阻滞的 TJA 患者比例从 63.1%增加到 87.0%（p<0.001）。未观察到安全事件或阻滞室相关的 OR 延迟。
实施区域麻醉阻滞室需要制定全面的商业计划，以确保有必要的资源来支持该计划。区域麻醉阻滞室是提高患者护理和 OR 效率的一种具有成本效益的方法。
