Ideas That Work: Put Nerve Block Expectations in Writing

Practical pearls from your colleagues

Most facilities communicate clearly with patients about what they are likely to experience perioperatively when receiving nerve blocks, but what happens when they return to their homes after discharge? At Yale New Haven (Conn.) Hospital, all patients who undergo regional anesthesia all go home with documentation on what nerve blocks do and what they can expect in those critical early hours when they first return home from surgery. It’s a concise single-page document, and it includes an FAQ on the questions the facility gets most often from concerned patients.

“It lets the patients know, ‘This is the nerve block you received and this is what you can expect,’” says Jinlei Li, MD, PhD, FASA, incoming vice chair of the American Society of Anesthesiologists’ Committee on Regional Anesthesia and Acute Pain Medicine and director of regional anesthesiology at Yale New Haven Hospital. “You’re coming home with a numb arm, which is completely expected, and you’re not going to have any pain sensations.” These things might seem obvious to providers, but Dr. Li knows firsthand how crucial it is to spell out all limitations and potential problems to patients who are often surprised by just how pain-free they are while the blocks are still in effect. 

In addition, before discharge, staff will go over everything item by item with not only the patients, but their caregivers as well. Making sure visitors and families are up to speed on the next steps, says Dr. Li, helps in the event patients, some of whom are coming out of regional anesthesia under the influence of benzodiazepines or opioids, don’t remember everything they’re told. OSM