days to outlast the pain
of surgery. It's also
portable. Unlike con-
tinuous catheters that
require patients to
carry around a bulky
infusion pump, stimula-
tion devices are so
small patients can stick
them directly to their
skin, leaving nothing to
carry.
There are potential
drawbacks. Peripheral nerve stimulation is significantly more expen-
sive than cryo. Plus, there are questions about its potency.
"According to the initial trials, nerve stimulation is nowhere near as
potent as a long-lasting local anesthetic," says Dr. Ilfeld.
But that's not necessarily a deal-breaker. If you can use a local, anes-
thetic-based single-injection nerve block, and get the patient out of
the PACU and home, then peripheral nerve stimulation becomes a
very potent analgesic, says Dr. Ilfeld.
How potent? Early feasibility studies show very low opioid use and
very low pain scores for procedures such as rotator cuff repairs, cases
that are traditionally very painful after surgery.
OSM
M A Y 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 6 7
• COMPANY COMING A number of drugs in various stages of testing could join
Exparel (liposomal bupivacaine) in the long-acting local analgesic market.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
