surgeons stealing our TAPs!
Started by GaseousClay
Yes. They are "inferior" blocks IMHO but better than no block at all. We need a double blinded study looking at their tap blocks vs 4 quadrant tap blocks performed by us.
Or, as my partners would say "I'm glad to be doing less work" so let them do the TAP blocks.
https://www.hpbonline.org/article/S1365-182X(17)30129-6/fulltext
https://academic.oup.com/asj/article/35/1/72/224765
According to our on-q rep, some of them are putting in their own catheters..... hmmmm
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I think it was started by a surgeon although it's a vascular vs IR kind of argument. I see the surgeons doing it without ultrasound very occasionally and there's really no point to that. Might as well just put in some local at the incision site and call it a day. Either way I think the tap block is greatly inferior to paravertebral block or thoracic epidural.
Our gyns don't do them at all but then again they can barely get their part down so yeah
Our gyns don't do them at all but then again they can barely get their part down so yeah
They have the abdominal wall exposed. Why wouldn't a thoughtful surgeon take advantage of that? I have "partners" that are of the same sour grapes world view, but their orientation is less patient well being than their own well being.
I’m seeing this too—some surgeons insist on doing their own “TAP” block
My understanding is that they can’t bill a dime for doing their own blocks, but we can obviously get a little more $$ for performing them. And ours definitely work better. What gives?
My understanding is that they can’t bill a dime for doing their own blocks, but we can obviously get a little more $$ for performing them. And ours definitely work better. What gives?
Definitely? Whether that is true or not, ours "slow them down."
yes definitely. The surgeons I see doing these “TAPS” are basically making a wheal just superficial to the fascia. They’d be much better off just injecting local around the incisions.
Yes, if you insist on making the OR wait while you TAP before prep or turnover that slows things down. But I have no problem doing TAPs in PACU if the surgeon is NFA
Yes, if you insist on making the OR wait while you TAP before prep or turnover that slows things down. But I have no problem doing TAPs in PACU if the surgeon is NFA
Nobody cares about this! Let them do it.
All they can do is make sure the local doesnt go in the peritoneum. If you don't go between the correct layers, there is really no point. It would be akin to dumping local in the subq instead of the epidural space.
I don't understand the slow them down argument. It takes me less than 5 minutes to do the block.
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What can I say? Some surgeons live in their own deluded world. The same surgeons complain when u put in a second IV before tucking arms in a potentially bloody surgery because it wastes time
thats why im happy im not in private practice you truly are the surgeon's B
I'm happy to be in private practice with good, fast surgeons instead of in academics watching the intern learn how to tie knots at 3 AM.
Isn't there more collegiality between surgeon and anesthesiologist in PP?? I mean you probably worj with the same people mpre frequently. In academics, there are a lot of dingus surgeons.
i generally want to do as little to patients as possible
Academic attendings will def not be sitting in a room at 3am
i guess it depends there are dinguses on both sides. in the non private world at least, you are paid regardless of what the surgeon tells you you can or can not do. Also a lot more room to tell them to wait patiently to put in more lines or do blocks if necessary for the patient. To each their own tho both have pluses and minuses
This is a reason I sometimes wish I were in academics, especially in regards to Obstetric anesthesia
I would never trust a surgeon for a block.
Who knew you could TAP block a ureter?
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D
deleted162650
That way it’s less painful when you cut it.
You can't do a tap block with laparoscopic guidance
Now this....THIS is the voice of experiece. All you young guns can put it your ultrasound guided, super duper catheters. Not I.
TAP = transversus abdominis perioneum!
Seriously. The more desire to poke and prod patients the more you set yourself up for complaints and complications.
Send them to cards for TAP clearance 😉
My point exactly
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