Regional anesthetic techniques.

Regional anesthesia has several distinct advantages over general anesthesia in the patient scheduled for ambulatory surgery. These include residual analgesia and a lower incidence of postoperative nausea and vomiting. With appropriate choice of regional technique and local anesthetic drug, earlier ambulation and discharge are often possible. These advantages, however, may be negated by the use of excessive sedation. Careful patient selection is required to achieve optimal results. Regional anesthesia requires more time to administer than does general anesthesia, and ideally should be performed in an induction area. However, use of such an area, or employment of techniques with a rapid onset of analgesia (e.g., intravenous regional of spinal anesthesia) may actually reduce the total amount of time a patient spends in the ambulatory unit [16]. Selected application of regional techniques will help convince surgeons, anesthesiologists, and nurses of the advantages of regional blockade and may ultimately lead to greater patient and surgeon satisfaction.