A regional anesthesia-based ''swing'' operating room model reduces non-operative time in a mixed orthopedic inpatient/ outpatient population Un modèle de salle « en rotation » basée sur l'anesthésie régionale en orthopédie réduit le temps non-opératoire dans une population mixte de patients ambulatoires et hospitalisés Abstract Purpose We recently reported on the efficacy of a new ''swing'' room model involving two alternating ORs and regional anesthesia in increasing operating room (OR) throughput in a dedicated ambulatory orthopedic surgery facility. The purpose of this study was to evaluate this model in a main OR suite setting with typical mixed inpatient/outpatient cases. Methods We conducted a retrospective matched-pair cohort study of 133 upper extremity surgery patients treated in the swing room model under ultrasound-guided brachial plexus blockade. We compared this cohort with case-matched historical controls treated in the traditional single OR model under general anesthesia. The primary endpoint was non-operative time, defined as the interval between skin closure and incision in the following case.Secondary endpoints included throughput estimated as the median number of cases per eight-hour day, postanesthesia care unit (PACU) bypass rates, and postoperative pain/ nausea and vomiting (PONV) intervention rates. Results Compared with the control group, non-operative times in the swing room group were faster (swing: median 19 min; interquartile range [IQR 8-31] vs control: median 57 min; IQR [49-65]; P \ 0.0001). In the swing room model, the estimated daily throughput was 33% greater (swing: median 5.6 cases; IQR [5.0-6.2] vs control: median 4.2 cases; IQR [4.0-4.4]; P \ 0.0001), and the PACU bypass rate was higher (swing: 60% vs control: 0%; P \ 0.0001). Fewer patients received postoperative opioids (swing: 20% vs control: 82%; P \ 0.0001) and treatment for PONV (swing: 2% vs control: 20%; P \ 0.0001) in the swing room model. Conclusion The implementation of a ''swing'' room care model based on ultrasound-guided regional anesthesia in a typical mixed inpatient/outpatient population decreased non-operative times, increased throughput, and improved recovery profiles compared with case-matched historical controls in the traditional model under general anesthesia. RésuméObjectif Nous avons re´cemment parle´de l'efficaciteṕ our l'augmentation du nombre de cas traite´s d'un nouveau mode`le de salle « en rotation » impliquant l'utilisation en alternance de deux salles d'ope´ration et l'utilisation de l'anesthe´sie re´gionale dans un centre spe´cialise´en chirurgie orthope´dique ambulatoire. L'objectif de cette e´tude e´tait d'e´valuer ce mode`le dans le cadre d'un ensemble de salles d'ope´rations accueillant aussi bien des patients hospitalise´s que des patients ambulatoires.