Newly Published
Editorial Views  |   September 2019
Regional Anesthesia: A Silver Bullet, Red Herring, or Neither?
Author Notes
  • From the Department of Anesthesiology, Perioperative and Pain Medicine (E.C.S., E.R.M.) and Department of Health Research and Policy (E.C.S.), Stanford University School of Medicine, Stanford, California; Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York (S.G.M.); Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California (E.R.M.).
  • Accepted for publication July 26, 2019.
    Accepted for publication July 26, 2019.×
  • Correspondence: Address correspondence to Dr. Sun: esun1@stanford.edu
Article Information
Editorial Views / Regional Anesthesia
Editorial Views   |   September 2019
Regional Anesthesia: A Silver Bullet, Red Herring, or Neither?
Anesthesiology Newly Published on September 4, 2019. doi:10.1097/ALN.0000000000002964
Anesthesiology Newly Published on September 4, 2019. doi:10.1097/ALN.0000000000002964
Today, clinicians in the perioperative realm are faced with increasing pressure from payers and policymakers to improve longer-term postoperative outcomes such as resource utilization (i.e., reduced readmission rates) and persistent opioid use after surgery. Many anesthesiologists believe that nerve blockade can play an important role in achieving these aims. This belief is fairly intuitive; a large body of literature has established that regional anesthesia is associated with increased mobility and decreased risk for many short-term complications.1  Moreover, the evidence strongly suggests that regional anesthesia is associated with improved pain control, which provides a basis for the assumption that it could reduce the risk of persistent postoperative opioid use. However, although widespread, is this belief actually true? In this issue of Anesthesiology, Hamilton et al.2  address this issue by comparing longer-term outcomes (i.e., readmission rates and costs within 7 days of surgery as a primary outcome and within 30 days as a secondary outcome) among ambulatory shoulder surgery patients who received peripheral nerve blockade to those who did not. Overall, these researchers found that nerve blockade was not associated with any difference in a composite outcome measure, although it was associated with a small increase in costs (which may largely reflect the costs of the block itself), and—in a secondary analysis—a modestly reduced readmission rate.