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Special Edition: Anesthesia - July 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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traditional drug manu- facturers, it's still a compounded prod- uct," says Dr. Berdahl. He believes that status is holding some facili- ties back from adding this conscious sedation option. Cost in another barrier. Dr. Berdahl's facility compared the hard costs of sublingual sedation tablets and IV sedation, and found the tablets added $1 to $2 to case costs. "The price of the tablets is bun- dled into the facility fee for cataract surgery," says Dr. Berdahl. "There's currently no separate billing mechanism." For eye centers that often operate with razor-thin margins, this could present a major obstacle. But Dr. Berdahl believes it's short- sighted to conduct an apples-to-apples cost comparison between the sedation options. "When we included the soft costs of the time that it took anesthetists or members of our nursing staff to prep and start IVs, the troches were actually the less expensive option," says Dr. Berdahl. Even if you don't technically come out ahead cost-wise, time and convenience are two factors to consider. "You definitely save time with the tablets because you can sedate the patient without having to find a vein," says Dr. Newsom. "There's no doubt it's a more conven- ient and easier option." While FDA status and cost are major obstacles, perhaps the greatest barrier is simply human nature. "I think one of the biggest factors [to a lack of widespread adoption] is a resistance to change," says Dr. Berdahl. "We've grown accustomed to always having IV access and a lot of anesthesia providers don't feel comfortable without it." J U L Y 2 0 2 0 • O U T P A T I E N T S U R G E R Y . N E T • 5 1 We've grown accustomed to always having IV access, and a lot of anesthesia providers don't feel comfortable without it. John Berdahl, MD

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