B141 Process improvement for ambulatory upper limb soft tissue trauma surgery

Background and AimsRegional anaesthesia (RA) is ideally suited to upper limb soft tissue trauma surgery (ULSTTS). Compared to general anaesthesia (GA), RA confers several benefits including: better analgesia; less postoperative nausea and vomiting; early independent ambulation; early hospital discharge and high patient satisfaction. The deliberate design of a ULSTTS patient pathway to incorporate RA may confer additional institutional benefits. We developed a RA based ULSTTS pathway and measured the influence on operating theatre time and cost.MethodsBaseline control theatre time data were gathered from theatre records from September and October 2020. Prospective data were collected from April to December 2021. A bottom up cost comparison data analysis for drugs and consumables used was performed. One hundred patients were followed-up by telephone at 24 hours for evaluation of pain (verbal rating score 0–10) and satisfaction (verbal rating score 0–5).ResultsFrom April 2021 to December 2021, we performed 238 ULSTTS surgeries under RA. When compared to matched GA controls, RA patients consumed 26 minutes less total operating theatre time per case. The median per case cost of drugs and consumables for ULSTTS using GA and RA were €227 and €20 respectively. The estimated time and cost saving attributable to RA during the study period was calculated as 6188 minutes (103 hours) and €49,266. At 24 hour followup the median [range] pain and satisfaction scores were 1 [0–5] and 5 [3–5] respectively.ConclusionsRA for ULSTTS is both feasible and effective within a bespoke patient pathway. Significant patient and institutional benefits can be derived