Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
Issue link: http://outpatientsurgery.uberflip.com/i/567827
1 5 0 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 | S E P T E M B E R 2 0 1 5 and ultrasound guidance. The entire procedure typically takes less than 10 minutes to perform. 1. I sterilely prep the mid-thigh region widely with chlorhexidine and then apply a clear plastic drape with the adhesive fenestration placed where the needle will be inserted. 2. The block nurse hands me my ultrasound probe, which I grasp through the plastic drape, thus maintaining a separate non-sterile field (probe) and a sterile field (needle insertion site). 3. With ultrasound, I identify the most important landmarks: the deep border of the sartorius muscle, the femoral artery, and, if possi- ble, the saphenous nerve (not always clearly visible in all patients). A N E S T H E S I A A L E R T Thanks to a recent FDA approval, multimodal pain strategists have another player to consider — an injectable NSAID that reduces opi- oid consumption when given post-operatively. Dyloject (diclofenac sodium), manufactured by Hospira, also adds a level of convenience. It can be administered in a small-vol- ume intravenous bolus over 15 seconds, versus the 15 to 30 min- utes that can be needed to administer full doses of other injectable non-opioid analgesics. In 2 controlled studies, patients who'd had abdominal/pelvic surgery or orthopedic surgery had lower pain scores and were less likely to require rescue medication (IV morphine) after being given Dyloject. In the abdominal/pelvic group, 63% of patients took rescue medication in the first 48 hours after surgery, compared with 92% of those given a placebo. The corresponding numbers were 74% and 92% for the orthopedic patients. Dyloject won't replace opioids, as the manufacturer is quick to point out, but it's one more way to help minimize their use. — Jim Burger NEW POST-OP OPTION Injectable NSAID Reduces Opioid Use z FAST RELIEF Dyloject can be administered in a small-volume bolus in just 15 seconds.