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
