Outpatient Surgery Magazine - Subscribers

Say Yes to Total Hips - March 2014 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://magazine.outpatientsurgery.net/i/272944

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Page 17 of 146

1 8 O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | M A R C H 2 0 1 4 IDEAS That Work T he use of a YAG laser to treat cataracts or an SLT laser to treat glau- coma requires the placement of a contact lens on the operative eye to focus the laser and to prevent the patient from blinking. Goniosol is applied first to cushion the eye beneath the lens. It's a thick, goopy solution, so it's necessary to irrigate the eye after the procedure to clear it. Oftentimes surgeons reach for balanced salt solution to irrigate, and BSS will do the job, but it's expensive: $7 to $10 for 5ml to 10ml of the high-grade, safe-for-intraocular-use fluid. Since I'm just irrigating the outside of the eye, sterile saline works just as well, and is much more cost effective: $5 for 100ml. That's about a tenfold difference in cost. Paul Chen, MD Center for Surgery of Encinitas Carlsbad, Calif. paulhchenmd@nclasik.com STERILE SALINE VS. BSS A Cost-Effective Irrigation Alternative INEXPENSIVE IRRIGATION You don't need BSS to clear the eye after laser work, when sterile saline will do. Pivotal studies have demonstrated the safety and efficacy of EXPAREL in patients undergoing bunionectomy and hemorrhoidectomy procedures. The clinical benefit of the attendant decrease in opioid consumption was not demonstrated. EXPAREL is a liposome formulation of bupivacaine indicated for administration into the surgical site to produce postsurgical analgesia. Important Safety Information: EXPAREL is contraindicated in obstetrical paracervical block anesthesia. EXPAREL has not been studied for use in patients younger than 18 years of age. Non-bupivacaine-based local anesthetics, including lidocaine, may cause an immediate release of bupivacaine from EXPAREL if administered together locally. The administration of EXPAREL may follow the administration of lidocaine after a delay of 20 minutes or more. Other formulations of bupivacaine should not be administered within 96 hours following administration of EXPAREL. Monitoring of cardiovascular and neurological status, as well as vital signs should be performed during and after injection of EXPAREL as with other local anesthetic products. Because amide-type local anesthetics, such as bupivacaine, are metabolized by the liver, EXPAREL should be used cautiously in patients with hepatic disease. Patients with severe hepatic disease, because of their inability to metabolize local anesthetics normally, are at a greater risk of developing toxic plasma concentrations. In clinical trials, the most common adverse reactions (incidence ≥10%) following EXPAREL administration were nausea, constipation, and vomiting. Reference: Gorfine SR, et al. Dis Colon Rectum. Dec 2011;54(12):1552-1559. For the Management of Postsurgical Pain The only single-dose local analgesic to UÊ Reduce or eliminate opioids with pain control for up to 3 days UÊ Without the need for catheters or pumps EXPAREL ® (bupivacaine liposome injectable suspension) ©2013 Pacira Pharmaceuticals, Inc., Parsippany, NJ 07054 EXP-AP-0039-201302 Please see brief summary of Prescribing Information on reverse side. For more information, visit www.EXPAREL.com Patient-Focused Pain Control That Lasts For Up To 72 Hours OSE_1403_part1_Layout 1 3/5/14 11:29 AM Page 18

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