Outpatient Surgery Magazine

Special Edition: Opioids - January 2020 - 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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of time and reduce the amount of opioids patients need." Still, single-shot intraarticular injections can be very effective for patients who don't want to go home with a catheter or pain pump or during cases involv- ing surgeons who don't want blocks placed. While the long-acting local anesthetic liposomal bupivacaine (Exparel) has enjoyed a virtual monopoly on the market, that could change in the near future. "There are a lot of exciting formulations in the pipeline," says Dr. Gan. For example, Heron Therapeutics has developed a combination of the long-acting local anesthetic bupivacaine and a low dose of the nons- teroidal anti-inflammatory agent meloxicam in a drug called HTX-011, which is slated for FDA review in March. "The nonsteroidal makes the pH level more neutral and therefore improves the absorption of the local anesthetic, which is a prolonged version of bupivacaine," says Dr. Gan. "The data suggests it can work for 48 hours, and perhaps up to 72 hours." Dr. Gan says another long-acting bupivacaine formulation in development by drug manufacturer Durect has been sent to the FDA for review and promises to provide several days of pain relief. He also points to a new local anesthetic collagen matrix, which works by impregnating a local anesthetic into the sponge-like material and gradually releasing it over 48 hours to 72 hours. J A N U A R Y 2 0 2 0 • O U T PA T I E N T S U R G E R Y. N E T • 3 1 • TRIED AND TRUE Patients who receive nerve blocks are less prone to opioid- associated side effects like respiratory distress or PONV, and are discharged more quickly following surgery. Pamela Bevelhymer, RN, BSN, CNOR

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