patient suffers breakthrough pain.
"Five or 6 years ago, we didn't want patients to have any narcotics,
zero," he says. "Now, we don't mind giving them a little. Small doses
are fine, we just want to keep them small. If we can limit their use, we
don't have to totally avoid them."
Spreading the word
The center's 2015 year-to-date opioid administration rate is 12.3%, and
Dr. Hickman says he's pleased with that. "In a hospital, it's probably
95%. In a lot of ASCs, it's 60 to 70%." And these efforts have attracted
notice from peers as well as patients.
"Blocks are a great patient satisfier," says Ms. Holder. "We've found
that people have researched Andrews and our use of blocks. They
want them." Adds Dr. Hickman, "We quickly got a reputation for less
pain. The word of mouth has been incredible."
He and his anesthesia colleague Brandon Winchester, MD, have
made it their mission to bring blocks and improved recoveries to a
wider audience of patients (see "Mastering Adductor Canal Blocks"
on page 86). Nearly every week the Andrews Institute ASC hosts
observing physicians and nurse support teams from across the coun-
try and around the world to teach them ultrasound-guided regional
block techniques.
"They leave ready to get more consistent, more predictable results,"
says Dr. Hickman, and this improvement is always welcome in every
surgical facility. "Regional is still way underutilized in this country."
— David Bernard
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