Regional anesthesia by nonanesthesiologists

Purpose of review As the evidence supporting the notion that regional anesthesia improves patient outcomes grows, utilization of regional anesthesia techniques has similarly increased. Best care should not be restricted by the background of care providers, however, the evidence replicating benefits of regional anesthesia when it is delivered by nonanesthesiologists is unclear. In this review, the provision of regional anesthesia by nonanesthesiologists is discussed so that readers can come to their own conclusions. Recent findings Regional anesthesia procedures are performed by nonanesthesiology physicians such as emergency physicians, critical care specialists, and surgeons. Patients benefit from the provision of regional anesthesia by these groups, but inconsistencies exist in training, service provision, and collaboration between these specialties and anesthesiologists. Nonphysician anesthesia providers also provide regional anesthesia. There are limited data on outcomes or benefits of this nonphysician-provided service, but consideration of team-based care and alternative models of care based upon geographical need is worthwhile. Summary The provision of regional anesthesia requires the accumulation of a suitable knowledge, skills, and behaviors that can be taught. Whilst it may not be appropriate for all techniques to be performed by all individuals, the possession of these competencies with the appropriate training and quality assurance means that more patients may ultimately benefit from the provision of regional anesthesia services. Correspondence to Amit Pawa, BSc(Hons), MBBS(Hons), FRCA, EDRA, Department of Anaesthesia, Guy's & St Thomas' NHS Foundation Trust, Great Maze Pond, SE1 9RT London, UK. Tel: +44 207 188 0644; fax: +44 207 188 0642; e-mail: amit.pawa@gstt.nhs.uk. Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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