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Snuffing Out Surgical Smoke - Outpatient Surgery Magazine - December 2019

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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D E C E M 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 • 8 7 I n the absence of antibiotic alternatives, physicians in the early 1900s had no choice but to treat every infec- tion with penicillin. Chronic pain went through a similar "penicillin phase." No matter the type of back pain — radicular, axial or arthritic — patients got an epidural steroid injection (and perhaps a recurring script for opioid painkillers). But with the advent of treatments like radiofrequency ablation and spinal cord stimulators, pain management is shedding its penicillin phase. "Pain management is just starting to come out of that one-size-fits- all approach to treating patients," says neurologist Vladimir N. Kramskiy, MD, the director of the Ambulatory Recuperative Pain Medicine Program at the Hospital for Special Surgery in the Bronx, N.Y. With facilities pressed to find opioid-free ways to manage chronic pain, the timing of these promising interventions couldn't be better. 1. Epidural steroid injections. Steroid injections in the Jared Bilski | Senior Associate Editor Chronic Pain in the Era of the Opioid Crisis Image-guided interventions like epidural steroid injections, radiofrequency ablation and spinal cord stimulators are in high demand. • SAFE AND STEADY With virtually all pain interventions being performed using some type of image guidance — whether it's X-ray, ultrasound or even CT guidance — the procedures are safe and easy to perform in an outpatient setting. Johns Hopkins Medicine

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