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Why Do ASCs Fail? - August 2015 - 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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1 2 O U T P A T 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 | A U G U S T 2 0 1 5 l e t t e r s @ o u t p a t i e n t s u r g e r y . n e t L E T T E R S & E - M A I L Does Exparel Work Any Better Than Bupivacaine? w Re: "Which Drug is Better for Post-op Pain Control?" (July Manager's Guide to Ambulatory Anesthesia, osmag.net/hBpEP3). I was disappointed to read your article, which seemingly set out to objectively eval- uate the value of Exparel based on a thor- ough review of available clinical data. The article's central premise is that the value of Exparel is derived from its ability to provide "better pain control" than standard bupiva- caine. This narrow interpretation leaves out a crucial and measurable benefit associated with Exparel, one that has broad-ranging implications for patient care and healthcare costs: opioid minimization. The ability to reduce the consumption of opioids has been shown to trigger a cascade of value-driving outcomes: lower rates of opioid-related adverse events and complications, faster recovery, shorter hospital length of stay, lower costs of care, and improved patient satisfaction and quality of recovery after surgery. The impact of Exparel on opioid consumption has been well-documented in literature, 1-3 but was overlooked in the article in favor of a simple and one-dimensional measure: pain scores. Pain, and hence pain scores, are highly subjective in nature, and while they must be a part of the equation when evaluating a new pain modality, they cannot be the only endpoint reviewed. In our institu- tion, we've evaluated the impact of Exparel across surgical proce- dures, with research presented at the Society of Critical Care Medicine 4 and accepted at this year's American College of Surgeons meeting demonstrating a reduction in opioids in both orthopedic and Ambulatory Anesthesia July 2015 Manager's Guide to Supplement to What we found may surprise you. p. 2 Better Pain Relief ? Which One Provides The revolution in post-op pain control p. 7 6 things MH experts want you to know p. 12 Does your anesthesia service make the grade? p. 37 S

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