The Louisiana First Circuit Court of Appeal ruled on December 28, 2006 that a CRNA may not rely on a “statement” issued by the Louisiana Board of Nursing that a CRNA may perform pain management procedures even if under the direction and supervision of a physician. A CRNA had asked the Louisiana State Board of Nursing for its opinion on whether a CRNA could perform pain management procedures. The Louisiana State Board of Nursing issued a “statement” which provided that the CRNA could perform procedures such as peripheral nerve blocks, epidural injections and injection of local anesthestics, if under the direction and supervision of the physician.

Spine Diagnostics Center of Baton Rouge, Inc. appealed a trial court ruling permitting the Louisiana State Board of Nursing to rely on its CRNA “statement” and allow CRNAs to perform interventional pain management.   The Louisiana First Circuit Court of Appeal held that the Louisiana State Board of Nursing “statement” was in fact a “rule” as defined under the Louisiana Administrative Procedure Act, and that the statement expanded the CRNA scope of practice.

The court prohibited the Louisiana State Board of Nursing from enforcing the “statement” and specifically prohibited the CRNA who asked for the opinion from performing any interventional pain management procedures.  Thus, in order to expand the scope of practice of a CRNA, the Louisiana State Board of Nursing will have to comply with the rule-making requirements of the Louisiana Administrative Procedure Act.