8 0 • 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
Implementing an effective opioid-
sparing regimen requires education
and communication, for both your
staff and your patients. Here are
some simple ways to improve both:
• In-services. At Montefiore
Hutchinson Metro ASC in the Bronx,
N.Y., anesthesiologists conduct fre-
quent in-services for the nurses who
work in the PACU. The sessions
cover the various risks of opioid use
and the types of questions they should be asking patients before
they're discharged.
• Provider briefings. Communication between surgeons and
anesthesiologists is paramount, and both sides need to be on
the same page. "The anesthesiologist needs to know the proce-
dure's expected pain level, and the surgeon needs to know the
modes of multimodal analgesia the anesthesiologist is using,"
says Gregory A. Liguori, MD, anesthesiologist-in-chief at the
Hospital for Special Surgery in New York, N.Y. These briefings
provide the opportunity for everyone to work together to create
a reasonable, personalized prescription for post-op opioids.
"You can now tailor prescriptions to the procedure," says Dr.
Liguori. "A knee arthroscopy may only need a few days' worth of
pills. A rotator cuff repair of the shoulder, even with multimodal
analgesia, is going to require more."
• Discharge instructions. Because you can't directly monitor
COORDINATED CARE
• MEETING OF THE MINDS Every member of the
surgical team must be on board with your facili-
ty's pain management strategy.
The Keys to Limiting Opioid Use