"actively trying to reduce opi-
oid use, but that opioids still
have a role to play."
Overall, the numbers are
good news to nationally
renowned pain expert Eugene
R. Viscusi, MD, professor of
anesthesiology and director of
acute pain management at
Jefferson University in
Philadelphia, Pa. "I think the
themes among anesthesia and
surgery are pretty consistent,
and those are that there's a
move away from opioids," says
Dr. Viscusi, an early and out-
spoken proponent of multi-
modal analgesia. "Both the nui-
sance side effects and the big-
ger problems related to sending patients home with opioids have made
their way into mainstream thinking."
The side effects are well documented — from "nuisances" like con-
stipation and nausea, to potentially life-threatening events like addic-
tion and respiratory depression.
Still, some suggest that the increasingly negative tone around opi-
oids has gone too far. "Narcotics are not intrinsically evil," says Louis
G. Stanfield, CRNA, PhD, DAAPM, of the Mercy Medical Center in
Sioux City, Iowa. Dr. Stanfield says he's open to reducing opioids, but
that he doesn't hesitate when he thinks they're called for. "Multimodal
analgesia implies the use of multiple agents for analgesia," he adds. Of
1 1 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • F E B R U A R Y 2 0 1 6
• HANDS-ON APPROACH Most providers are embracing a multimodal
approach that reduces, but doesn't necessarily eliminate, opioid use.
