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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analgesia and anesthesia they'll be getting and why," says Shane C. Dickerson, MD, the director of outpatient anesthesia services and an assistant clinical professor of anesthesiology at Keck School of Medicine. "We use statistics to drive home why we go above and beyond to avoid unnecessary opi- oid usage." For example, they tell patients, "We're using an opioid-sparing protocol because the literature shows there's a 6% to 8% chance you could get hooked on opioids down the line, and we're going to do everything in our power to prevent that from happening." Patients who are scheduled for surgery at UPMC are evaluated to determine how to optimize them for surgery and map out perioper- ative and post-operative pain management plans. "Setting reason- able expectations goes a long way to improving how patients react to pain," says Dr. Luke. "You need to set expectations that patients will feel some pain, even minor discomfort, as early as possible." 2. Improve fluid management The growing movement to do away with pre-op fasting ultimately impacts how the body reacts to the stress of surgery. Dr. Luke says gas- tric emptying occurs within a couple hours in non-diabetic patients or in patients without severe gastroparesis, meaning aspiration rates are low in patients who are permitted to drink clear fluid or a carbohy- 4 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 2 0 • KEEP IT REAL Set realistic expectations for patients about the post-operative pain they're likely to experience. Pamela Bevelhymer, RN, BSN, CNOR

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