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houlder surgery is notoriously painful, but it's not uncommon for
post-op shoulder patients at the Andrews Institute for
Orthopaedic & Sports Medicine in Gulf Breeze, Fla., to never have
to take a pain pill, says Gregory Hickman, MD, medical director
and director of anesthesia. Like a growing number of surgical
facilities, the famed Andrews Institute has tapped into the magic of a multi-
modal approach to pain management.
The traditional pyramid of pain management involves giving more and more
narcotics, depending on whether pain is mild, moderate or severe. Dr. Hickman
has turned that pyramid on its head. Less than 10% of his patients get narcotics
in the recovery room.
"My pyramid is totally different," he says. "The primary thing we do is regional
anesthesia. If we can do a regional anesthesia, we're going to do it, unless it's
P A I N M A N A G E M E N T
Multimodal's
Multiple
Benefits
There are plenty
of ways to reduce
opioid use and
still stay on top
of post-op pain.
Jim Burger
Associate Editor
BUILDING BLOCK Regional
anesthesia can be the cornerstone
of an effective multimodal
approach to pain management.
Pamela
Bevelhymer,
RN,
BSN
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