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Making sense of block "success" in ambulatory anesthesia practice.

Beauty is in the eyes of the beholder. So too is success. In the ambulatory perioperative setting, a beautifully performed nerve block can be successful or unsuccessful depending on the beholder. A successful nerve block for ambulatory surgery thus depends on the priorities of each key stakeholder in the perioperative environment, that is, the anesthesiologist, the surgeon, the patient, and the hospital administration. As these priorities may be starkly disparate, the definition of a ‘‘successful’’ nerve block for ambulatory surgery is grossly inconsistent in the regional anesthesia (RA) literature. The ultimate comprehensive and clinically important meaning of a successful nerve block relevant to the rapid turnover practice of ambulatory anesthesia remains ill defined. In an attempt to uncover the true definition of block success for ambulatory surgery, we reviewed the most frequently cited articles in the contemporary literature that primarily aimed to evaluate the efficacy of nerve blocks for ambulatory surgery.