Clinician perceived barriers to the use of regional anaesthesia and analgesia

Barriers and facilitators to implementing a regional anesthesia service in a low-income country: a qualitative study

“…This same sense of gratitude may have biased our results, as our data spoke of regional anesthesia-specific barriers in relative paucity. For example, very few of the participants mentioned common misgivings expressed in Western countries such as: time taken for block learning; slowing of list turnover; consequences of failed blocks; potential complications such as local anesthesia toxicity and nerve damage; and patient anxiety [26]. Both local and international authors of this study observed difficulty amongst Rwandan staff in expressing negative opinions about volunteer intervention for two reasons: a sense of gratitude, and the non-confrontational nature of Rwandan verbal communication.…”

Barriers to Effective Pain Management

“…Recently I heard of the problems facing recovery staff when a particular anaesthetist was reluctant to prescribe adequate pain relief for his patients. Despite requests he would not reconsider his prescribing -a major barrier for effective pain relief (There may be many reasons for this: a survey of anaesthesia clinicians concerning their use of regional analgesia revealed that many overrated the risk of complications and, while 100% said they used or would allow this technique, in practice only 6% actually did (Boyd et al 2006)).…”

“…Despite requests he was would not reconsider his prescribing, a major barrier for effective pain relief. There may be many reasons for this; a survey of anaesthesia clinicians concerning their use of regional analgesia revealed that many overrated the risk of complication, and whilst 100% said they used or would allow this technique, in practice only 6% actually did (Boyd et al 2006). So an audit was undertaken over a 1-month period.…”

Nurse‐Led Femoral Nerve Block Service for Patients with Fractured Neck of Femur

“…McQuay and Moore (1998) reported that the use of local anaesthetic has a perceived advantage because it can deliver complete pain relief by interrupting pain transmission from a localised area, thereby avoiding generalised adverse drug effects from opioids and NSAIDs. Boyd et al (2006) describe regional analgesia techniques as providing superior postoperative analgesia, higher levels of patient's satisfaction and reduced morbidity and mortality in patients with certain comorbid conditions. Local anaesthetic nerve blocks either as a single shot or continuous infusion technique are, therefore, particularly suited to elderly patients.…”

“…There is some evidence that an FNB may give better analgesia for lower, inter-trochanteric fractures than for higher cervical fractures, but significant improvement in pain scores are seen for both types (Fletcher et al 2003). Use of local anaesthetic blocks perioperatively has been associated with a reduction in pain and fewer complications post-operatively (Boyd et al 2006). In addition, improved pain relief will allow patients to move around the bed more easily, therefore reducing the risk of developing pressure sores, and patients will be able to sit up to eat and drink to ensure adequate nutrition.…”