There's still time to obtain discounted pricing for Outpatient Surgery Magazine's 2010 OR Excellence conference and participate in our pre-registration contest. The deadline has been extended to Friday, Sept. 10. Don't miss the opportunity to lock in savings on the surgical conference of the year and enter into the running for more than $10,000 in prizes.

Early registrants receive a $100 discount off the full registration price for the conference - taking place from Oct. 27 to Oct. 29 in Ft. Lauderdale, Fla. - guarantee their reservation at the meeting and secure discounted accommodations at the Harbor Beach Marriott Resort and Spa, the center of conference activity.

In addition, all attendees who have paid in full by Sept. 10 will be entered into a drawing for prizes, including free sunset cruises and the grand prize, an upgrade to the Marriott's $2,000-a-night Vice Presidential Suite during OR Excellence and for 2 extra nights - a $10,000 value.

For more information, visit the OR Excellence website.

Steven Archibald

In addition to its laparoscopic applications, the da Vinci surgical robot might be able to perform complex regional anesthesia from remote locations, according to researchers at the University of Florida College of Medicine in Gainesville.

The researchers first attempted an ultrasound-guided, single-injection nerve block on a "phantom" patient, a model that provided a realistic view of what physicians would see if they were performing an actual block. After the ultrasound probe was manually placed on the phantom and secured with one of the robot's arms, anesthesiologists turned their backs to the phantom and used the da Vinci's controls to identify nerve structures, pick up the needle, position it near a target nerve and inject the drug.

Next, researchers used the da Vinci to place a more complex perineural catheter (captured on video) for a continuous nerve block. While many of the technique's steps could be accomplished with the robot, manual assistance was still required to complete aspects of the block, including the placement of the ultrasound transducer and the opening of medication ampoules.

The researchers note that automated anesthesia is still limited by the need for physician presence to provide patient care and manage potential complications, the da Vinci's multi-million dollar price tag and the fact that some steps of the block's placement had to be performed manually. They also admit their research, which appears in the September issue of the journal Anesthesia & Analgesia, is purely experimental. "Even if optimized for anesthetic practice, robotic-assisted anesthetic procedures are not likely to become a part of routine anesthetic practice," they write.

Still, the study demonstrates that remote regional anesthesia is possible. Stephen L. Shafer, MD, professor of anesthesiology at Columbia University and Anesthesia & Analgesia's editor-in-chief, believes "a highly trained anesthesiologist could provide dozens of specialized nerve blocks to patients around the world in a single day if future studies show that [the technology] is practical."

Daniel Cook

While most surgical patients report marked improvements following surgery, a significant number complain of less vitality and more pain in the year after their procedures, according to Dutch researchers.

One year after surgery, 1 in 4 patients reported feeling less vigor than they did prior to their surgeries, and 1 in 7 reported experiencing more pain than before, says a study published online by the British Journal of Surgery.

"The strongest predictor of pain intensity at follow-up was the level of pain in the first 4 days after the patient's operation," says lead author Madelon Peters, PhD, of the department of clinical psychology at Maastricht University in the Netherlands.

She and her colleagues interviewed 401 patients who had undergone non-emergency procedures ranging from cosmetic to orthopedic surgery. Interviews took place before surgery and 6 months and 1 year afterward.

Most of the changes that patients reported in their quality of life, such as pain, mobility and emotional issues, occurred during the first 6 months after surgery. As a result, says Dr. Peters, post-op monitoring is most important during this period. "Poor recovery may have lasting consequences," she says.

Kent Steinriede

The surgical facility manager's job is a real pressure cooker. We all know that. But there are moments of great joy and satisfaction to be had, too. We want you to tell us about the most rewarding part of your job. Is it building great relationships with physicians and staff, sending satisfied patients home, cutting costs and growing profits or another aspect? Cast your vote through our online poll, and check back next week for the results.

Last week's InstaPoll asked who's anesthetizing patients at your facility: anesthesiologists, CRNAs or a combination? We received 259 responses, with the results closely grouped.