Authors: Gabriel R A et al.
Cureus 17(10): e95836, October 2025. DOI: 10.7759/cureus.95836
This quality improvement pilot study evaluated the feasibility of implementing a regional anesthesia consulting service in a hospital Emergency Department (ED) and its effect on patient experience and pain control. The project was initiated to address limited ED access to regional blocks despite growing evidence of their superiority over opioids in reducing pain and postoperative opioid use. Two fellowship-trained regional anesthesiologists were made available for five months to perform ultrasound-guided nerve blocks at the request of ED physicians through an electronic communication system.
A total of 22 patients received blocks for acute pain conditions such as femoral or humeral fractures, rib fractures, occipital neuralgia, and pelvic pain. Fourteen patients completed follow-up surveys on post-procedure day one. Most rated their pain relief as “Excellent” or “Very Good” (64%) and reported high satisfaction with their care experience (79%). Nearly all patients (79%) said they would “Strongly Agree” to use the same pain relief method again and recommend it to others. About two-thirds (64%) were discharged home directly from the ED, suggesting effective analgesia that supported early discharge.
While the service was well received, utilization was limited by cultural and logistical barriers, including low provider awareness and the regional team’s restricted hours. Some ED physicians expressed interest in performing blocks themselves but cited lack of training and time as barriers. The authors note that most blocks performed are within the scope of ED practice, and prior studies have demonstrated their safety when ED providers receive proper ultrasound-guided training.
What You Should Know:
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Regional anesthesia can provide effective, opioid-sparing pain control in the ED and facilitate earlier discharge.
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Patients overwhelmingly reported high satisfaction with pain relief and care quality.
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Key barriers to wider adoption include limited provider training, workflow logistics, and lack of dedicated personnel.
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Integration of structured block training for ED physicians and streamlined consultation systems could expand use.
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Future randomized studies comparing regional anesthesia with standard opioid therapy are warranted to validate outcomes and cost-effectiveness.
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