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Her Loss, Their Gain - October 2019 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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fully structured multimodal regimen a virtual necessity if you want to provide cutting-edge patient care that's heavy on pain relief but light on opioids. Beyond the buzzword The phrase "multimodal pain management" has been thrown around often in recent years, so it's easy to lose track of what it actually means. From an outpatient perspective, a multimodal approach to analgesia can be boiled down to attacking pain with a combination of methods. • Interventional techniques, including spinal anesthesia and ultra- sound-guided peripheral nerve blocks are among the most effective opioid-sparing analgesic tactics outpatient facilities have at their dis- posal. "If there's an opportunity to do regional anesthesia for patients, we're going to take it," says Curtis Choice, MD, MS, director of anes- thesiology at Montefiore Hutch-inson Metro ASC in the Bronx, N.Y. And why shouldn't they? The effectiveness of regional blocks has grown exponentially thanks to advances in ultrasound guidance technology. "Historic-ally, regional anesthesia was done almost blindly with a nerve stimulator," says Dr. Choice. "But nowadays, we can do a lot of these blocks safely and efficiently by going right at the nerves where the generation and propagation of the pain impulse occurs." With ultrasound guidance, the precision and safety of block place- ment are remarkable. Anesthesiologists can do everything from visu- alizing the brachial plexus and seeing the needle sheath to gradually giving a local anesthetic through hydrodissection. "You can see the nerves and blood vessels, so you have less incidence of issues like local anesthetic systemic toxicity," says Dr. Choice. "You have a greater safety profile because of the technology." O C T O B E R 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 7 3

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