At Montefiore, sur-
geons perform numer-
ous arthroscopic
orthopedic proce-
dures, and a signifi-
cant amount of these
are done with the aid
of regional anesthesia.
For example, shoul-
der arthroscopy
patients receive inter-
scalene brachial
plexus blocks and, in
some cases, a superfi-
cial cervical plexus
block. For extremity
procedures, anesthe-
sia providers place
supraclavicular
brachial plexus blocks in combination with intercostobrachial nerve
blocks.
• Systemic pharmacological therapies. Multimodal drug therapies
are built using core agents such as NSAIDS, alpha-agonists, NMDA
receptor blockers, membrane stabilizers like pregabalin (Lyrica) and
dexamethasone. The ultimate goal is to maximize the drugs' benefits
for analgesia in the most opioid-sparing way possible, while also
minimizing the risks that are inherent with the medications because,
as Dr. Choice puts it, "Nothing's free — everything that we give also
has some side effects."
When it comes to structuring your multimodal drug regimen, you need
7 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 1 9
• GOOD TALK Having anesthesia providers explain to patients everything they can
expect post-op is a critical part of the education process.
