ready or willing to
walk out of your
facility hours after
they walked in.
Look closely and
you'll notice there
are plenty of excit-
ing things happening
at the head of the
OR table, beginning
with efforts to
address a national
crisis.
1. Opioid-sparing pain management
That opioids are a major concern isn't big news. That in many ways
they're an even bigger problem than previously realized may be the
more important recent revelation.
"We now know that the intraoperative use of opioids — particularly
potent lipophilic ones like fentanyl, sufentanil and especially remifen-
tanil — produce hyperalgesia intolerance," says Eugene Viscusi, MD, a
professor of anesthesiology and the chief of pain medicine at Thomas
Jefferson University Hospital in Philadelphia, Pa. "In other words, they
literally cause more pain and higher opioid requirements. It's pretty
alarming to realize that you're giving what you think are pain drugs
only to find out they actually increase pain and opioid use."
By now you know that the opioid crisis has led to a spike in ongoing
efforts to find analgesic combinations that serve as opioid alternatives
(as well as a spike in the use of the word multimodal).
"We have a lot more tools available if we want to avoid opioids,"
1 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 1 9
• SCREEN SHOT Video laryngoscopes continues to evolve and could someday replace
direct laryngoscopy as the go-to approach for airway management.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
