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Video Interview

Dr Nick Scott

For 16:9 format video

 

Can you tell me about your role at the hospital?

I’m Nick Scott and I'm the lead clinician for pain management in the hospital and I am a consultant cardiothoracic and orthopaedic anaesthetist in the hospital and have been involved in setting up the enhanced recovery in the hospital in the last four or five years.


What role does the anaesthetist play in the Rapid Recovery/enhanced recovery programme that you have implemented?

It’s very important to understand that everybody plays a role in this programme and it’s a multi-disciplinary team game, so it’s a team sport that everyone should buy into and if there is no buy in, no one can help. When you buy in to it, the anaesthetist plays a very central role because they are responsible for the drugs the patients receive, both pre intra and post operatively, and all the potential morbidity that is associated with them. We are there to ensure that the surgeon is able to operate in nice stable conditions and that the patient recovers quickly and smoothly from the anaesthetic into the post-operative recovery phase and extending the anolgesia through that phase until they are discharged. 

 

Has your practice changes and if so, how?

My practice has changed a lot in terms of the techniques that we use, and in the last four years we have gone away from, we used to used routinely continuous epidural infusions for knee and hip arthroplasty and the evidence now does not support those for routine use, so we are using in about 95% + of our patients wound infiltration plus multi-modal analogises for enhanced recovery.

 

What benefits have you seen from the programme?

There are several very obvious benefits and several subtle ones. The important thing is that we are able to do away with urinary catheters for the vast majority of our patients, we see very low blood transfusion rates, which is a very interesting side effect of the technique that needs to be investigated further. We’re seeing analgesia that is as good as what was previously the “gold standard” of epidural anaesthesia, and the patients are up mobilising much quicker in the peri-operative period.        


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Video Information

Interview with Dr Nick Scott, Consultant Anaesthetist

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