New ASA 2026 Perioperative Pain Guidelines released—Essential Anesthesia’s Alignment on UGRA, POCUS, and ERAS protocols

Essential Anesthesia is committed to delivering safe, evidence-informed, patient-centered perioperative care. We support the routine use of Ultrasound-Guided Regional Anesthesia (UGRA) for postoperative analgesia when clinically appropriate, the adoption of Point-of-Care Ultrasound (POCUS) across perioperative settings, and the implementation of Enhanced Recovery After Surgery (ERAS) protocols in partnership with our facilities.

OUR GOAL

To be a leader in UGRA, POCUS, and ERAS—advancing patient comfort, safety, and value while supporting the surgeons and facilities we serve.

WHY THIS MATTERS

UGRA, POCUS, and ERAS are complementary practices that improve patient experience and operational performance by:

• Reducing opioid exposure and related side effects

• Improving pain control, ambulation, and patient satisfaction

• Shortening recovery time and, when feasible, length of stay

• Supporting consistent, high-reliability care pathways

CLINICAL PRINCIPLES 1.Patient selection & safety: Regional techniques are offered when benefits outweigh risks and align with patient preference, surgical requirements, and institutional policy.

2.Standardization with flexibility: We standardize core workflows and set minimum standards while allowing site-specific tailoring to resources and case mix.

3.Interdisciplinary alignment: UGRA and ERAS implementation is coordinated with surgeons, nursing, pharmacy, and rehabilitation teams to ensure end-to-end care.

TRAINING & PROFICIENCY

We are dedicated to supporting advanced clinician training and measured proficiency, and availability of these programs across our client facilities Essential will:

• Support structured education, simulation, and proctorship for UGRA and POCUS

• Maintain competency verification and ongoing skill development

• Share protocols, checklists, and reference materials for bedside use

IMPLEMENTATION & SUPPORT

Essential will partner with our clinical providers and facilities to:

• Build and maintain block carts, ultrasound access, and documentation tools

• Stand up ERAS pathways with clear order sets and metrics

• Establish consult workflows for postoperative analgesia and rescue plans

MEASUREMENT & CONTINUOUS IMPROVEMENT

We will track key outcomes—pain scores, opioid use, recovery milestones, complications, and patient satisfaction—and use these data to refine practice and expand access.

REFERENCES

1.          Abdallah FW, Brull R. Is ultrasound guidance advantageous for regional anesthesia? Anesthesiology. 2011;134(1):15–29.

2.          Davis JJ, Swenson JD. Ultrasound-guided regional anesthesia: current concepts and future trends. Curr Opin Anaesthesiol. 2019;32(5):597–604.

3.          Sites BD, Chan VW, Neal JM, et al. The American Society of Regional Anesthesia and Pain Medicine and the European Society of Regional Anesthesia and Pain Therapy Joint Committee recommendations on UGRA education and training. Reg Anesth Pain Med. 2010;35(Suppl 1):S1–S8.

4.          ASRA (American Society of Regional Anesthesia and Pain Medicine). Guidelines for the performance of ultrasound-guided peripheral nerve blocks. ASRA Practice Advisories.

5.          Moore CL, Copel JA. Point-of-care ultrasonography. N Engl J Med. 2011;364:749–757.

6.          Shokoohi H, Boniface KS, Hamilton AJ, et al. Point-of-care ultrasound and the evolving role of advanced practice providers.JAAPA. 2019;32(6):1–9.

7.          Kehlet H, Wilmore DW. Evidence-based surgical care and ERAS pathways: improving outcomes. J Am Coll Surg. 2008;207(3):3–5.

8.          ERAS® Society. Clinical guidelines for enhanced recovery after surgery across specialty pathways. ERAS Society Publications.

9.          Chung F, Liao P, Elsaid H. ERAS implementation in ambulatory and outpatient surgery. Curr Opin Anaesthesiol. 2021;34(6):695–702.

10.    American Association of Nurse Anesthesiology (AANA). Practice considerations for ultrasound-guided regional anesthesia and POCUS. AANA Clinical Resources.

11.    Kirksey MA, Haskins SC, Cheng J, et al. Ultrasound-guided regional anesthesia and postoperative outcomes: a systematic review.Pain Med. 2016;17(6):1012–1032.

12.    Cohen S, et al. Multimodal analgesia and regional anesthesia in ERAS pathways. Anesth Analg. 2018;126:1731–1740.

13.    Guay J, Kopp S. Peripheral nerve blocks and postoperative pain management: Cochrane review. Cochrane Database Syst Rev. 2021.

14.    Apfelbaum JL, et al. Practice guidelines for acute pain management in the perioperative setting. ASA Task Force on Acute Pain Management.

15.    Haskins S, et al. Block room and organizational models to support UGRA. Reg Anesth Pain Med. 2019;44(2):217–224.