"Regional
blocks are a
huge part of
our ambulato-
ry center's
success."
By their own
count,
Andrews'
anesthesia
team has
administered 20,253 blocks between the center's 2007 opening and this
past June, for an average of 300 a month. But regional isn't the only
route to effective post-op, non-opioid pain control. "Blocks are the way
to go, but if you can't give a block, we have protocols set up for alterna-
tives," says Ms. Holder.
A 1,000 mg dose of IV acetaminophen was standard for a range of
procedures, she says, until the manufacturer was acquired by a larger
firm and the product's price doubled, after which the center switched
to an equivalent oral dosage. The anesthesia providers' pain manage-
ment toolbox also includes the analgesic gabapentin (300 mg orally),
the steroid dexamethasone (for its anti-inflammatory and anti-nausea
effects) and local anesthetics (both single-shot and continuous
catheter infusion pumps), among other options for reaching different
pain receptor sites.
Dr. Hickman notes that he and his staff are not opposed to the use
of opioids when they're necessary, and on occasion they are. For
example, sinus surgeries, tonsillectomies, adenoidectomies and
other ENT cases can be quite painful, but there's no regional block
for the head. And opioids are an effective remedy when a blocked
7 8
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 | S E P T E M B E R 2 0 1 5
z MAN WITH A PLAN "Regional blocks are a huge part of an
ambulatory center's success," says Gregory Hickman, MD, med-
ical director and director of anesthesia at the Andrews Institute.
Andrews
Institute
ASC
O R E X C E L L E N C E AWA R D S O R E X C E L L E N C E AWA R D S