To the Editor
Having recently passed a major milestone, this “older” anesthesiologist would like to share her personal method of safely testing adequacy of regional anesthetic blocks when the patient is adequately sedated (“poofed”?). (1)
The electrocautery grounding (Bovie) pad that feels like the Arctic tundra when initially placed upon the unanesthetized patient’s skin is but a “gooey’ sensation to the lucky patient under conduction anesthesia. The patient is spared the frightening sight and sting(!) of a sharp needle to “check the level of the block.” The anesthesiologist doesn’t create unsightly and unhealthy bloody needletracks on the patient’s body. The nurse, instead of running for ice chips for the anesthesiologist to check the level of anesthesia, concentrates on prepping the patient so the ever-impatient surgeon can cut. No time is wasted.
One word of caution remains. The Bovie pad must be placed initially on the anesthetized side. Otherwise even the most comfortably sedated patient under the best unilateral conduction block will complain of a painfully intense cold sensation.
I hope this practice pointer proves that neither old age nor treachery is necessary to deliver safe and effective regional anesthetics!(2)
Wendy B. Kang, M.D., J.D.
Assistant Professor, Department of Anesthesiology The university of Texas
Southwestern Medical Center at Dallas, TX
- Shea, K: Is patient adequately sedated? (letter). APSF Newsletter Spring 1994; 9:12.
- Lm, DE: Are ‘older’ anesthesiologists necessarily incompetent, as says “callow youth?’ (letter). Ibid.