Complex Information for Anesthesiologists Presented Quickly and Clearly

We queried the United States National Library of Medicine’s to identify all publications found using the key word “femoral nerve block” alone and with the key word “ultrasound”; 446 and 64 publications, respectively, were identified between 1952 and 2014 and are graphically represented. A recent literature review identified the first report of ultrasound guidance in regional anesthesia.1 Separately, we queried the Centers for Medicare & Medicaid Services’ Provider Utilization and Payment Data* to identify all femoral nerve blocks billed to Medicare by individual practitioners during 2012. Of the 3,067 distinct procedures reported, 2 represented femoral nerve blocks (Healthcare Common Procedure Coding System codes 64447 and 64448). Identified were 39,784 unique practitioners, of which 224 (0.56%) had billed for a femoral nerve block. The total number of Medicare patients per practitioner was computed by adding the number of patients for each type of femoral nerve block. The billing ZIP code of each practitioner was converted to a latitude and longitude, which was visualized in conjunction with a map of the United States using R (The R Foundation for Statistical Computing, Vienna, Austria, package zipcode). Each circle represents the geographic location of an individual practitioner with the area of the circle proportionate to the number of patients who received femoral nerve blocks from that practitioner in 2012.

Infographic created by Jonathan P. Wanderer, Vanderbilt University School of Medicine, and James P. Rathmell, Massachusetts General Hospital/Harvard Medical School. Address correspondence to Dr. Wanderer: Illustration by Annemarie Johnson, Vivo Visuals.

Ultrasound and its evolution in perioperative regional anesthesia and analgesia.
Best Pract Res Clin Anaesthesiol