Why one surgeon started doing his own adductor canal blocks

Traditionally, an anesthesiologist places an adductor canal block, if the patient needs one, following a knee replacement procedure. 

Robert Jamieson, MD, hip and knee replacement specialist at Roseville, Calif.-based Orthopedic Specialty Center of Northern California, told "Becker's ASC Review Podcast" that learning how to do the procedure himself has made his practice more efficient.

Note: This is an edited excerpt. Listen to the full podcast episode here.

Question: Why did you start placing your own adductor canal blocks versus having the anesthesiologist team doing them?

Dr. Robert Jamieson: The hospital that I was at for a long time, the anesthesiologists were able to place the adductor canal blocks in the recovery room. Then they switched their protocols and said, "Well, it's a procedure. It should be done in the operating room." So that was one of the first triggers for me.

When you're trying to do four or five joints in one room, and you're trying to flip that room and trying to get the turnover crew in, I have some really good anesthesiologists I work with, but it really took a lot of time. In a day of four or five joints in one room, you're talking an additional 40 or 50 minutes and as surgeons, it just drives you crazy waiting for that room to turn over.

Another [reason] was we had some anesthesiologists that didn't know how to place the blocks. And I finally just said we're gonna kind of bail on this for a little while. 

[And then I heard about] a surgeon in Alabama that was starting to put these in place. I got a hold of him and we talked. I watched some, talked to him, did some cadaver lab work and then we started placing them and it's been really, really nice. 

It takes me about three minutes to place it and secure it on the knee. The pump lasts about four to five days and they get great pain relief. It's been really good for my practice. I do it both at the surgery center and at the main hospital. It doesn't matter who my anesthesiologist is anymore. We don't have to worry about the length of time for the turnovers.

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