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sparing effect is desirable, says Dr. O'Neill. They provide an alternative to opi-
oids in many cases, and in those cases where opioids are necessary, smaller
doses are usually all that is necessary, adds Mr. Rioux.
Exparel, injected into the soft tissues of the surgical site, is a single-dose
local analgesic. A single intraoperative injection treats pain at the source
with reduced opioid requirements for up to 72 hours. "Sometimes we use
bupivacaine for longer action on patients with more invasive-type proce-
dures or those with long rides home," says Ms. Cherniawski. Ofirmev, admin-
istered as a 15-minute intravenous infusion, "is great for kiddos and people
with narcotic intolerance," says Dr. Weiss. "From a business standpoint, it
helps us bring in more patients — often the ones who have had unpleasant,
painful experiences with another physician."
Regional's role
Regional anesthesia, a big part of why more invasive cases are being done on
an outpatient basis, is increasingly demonstrating outstanding clinical results,
minimizing recovery room stays, saving money and enhancing patient satisfac-
tion. Regional blocks play a valuable part in the multimodal approach and
help reduce both peripheral and central sensitization, says Dr. Frederick.
Regional anesthetic techniques "trick" the body, preventing painful impulses
from reaching the spinal cord.
"We are able to discharge patients to home sooner than a required 23-hour
observation or outright admission for post-op pain management," says the Texas
CRNA. "Regional anesthesia is frequently the only modality needed for the
immediate post-operative period," adds Mr. Rioux. OSM
E-mail
doconnor@outpatientsurg ery.net
.
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