48 Evaluation of Regional Anaesthesia Practice in Plastic Surgery; a Retrospective Cross-Sectional Study

Abstract

Abstract Aim Our project aimed at assessing the regional anaesthesia practice in plastic surgery department Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. Method It is a retrospective study associated with a questionnaire filled by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). Criteria of suitable candidates for regional block were put by the consultant anaesthetists. Results For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the criteria. However only 7 patients had their operations under regional block and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled by both plastic surgeons and anaesthetists of different training level to find out the reasons behind the obvious preference of general over regional anaesthesia even if this was against the patients’ interest. Forty-four clinicians filled the questionnaire, among which was 23 plastic surgeons and 21 anaesthetists. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. Conclusions The recommendations were in 5 main accesses which areProtocols and pathways for regional blocksMore training opportunities for anaesthetists on regional blocksProviding a separate block room in the hospitalBetter communication between surgeons and anaesthetistsPatient education about the benefits of regional blocks