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 • 5
members who face untold challenges. When a loved one suffers
from addiction, the struggle impacts numerous lives, causing a wide-
spread emotional and financial toll that you can't fully understand
unless you live through it. Let's do what's necessary to improve how
we manage perioperative pain, so others don't have to endure what
my family has had to overcome.
Start by communicating with patients before the day of surgery to set
reasonable expectations about how they'll feel after surgery and to edu-
cate them on how you'll manage their discomfort reasonably and safely.
Patients need to understand that they will experience some pain after
surgery, and that your team will do everything in their power to mini-
mize it.
There are many alternative or adjuvant techniques available to
help you reduce or even eliminate the use of opioids, from regional
blocks to multimodal anesthesia protocols, which you'll read about
on the following pages. Over the past decade, anesthesia providers
have developed more versatile regional block techniques that have a
greater chance of success thanks to the use of ultrasound-directed
needle placements. We routinely use IV or PO acetaminophen,
NSAIDs and gabapentinoids. We have developed enhanced pre-op
protocols and post-op algorithms, which are encompassed in
Enhanced Recovery After Anesthesia (ERAS) programs. We aren't as
reliant on opioids at any phase of the perioperative period. More
than ever, we work with other surgical team members to implement
multimodal regimens that help us stay ahead of pain.
Safe and comfortable
My adopted home state of Florida, as the epicenter of the pill mill
phenomenon, played an especially egregious role in the cause of