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Battle Post-op Pain Without Opioids - April 2016 - 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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from the refrigerator, has to be used or discarded after 14 days. Preloaded syringes containing succinylcholine can maintain their potency for 90 days. 3. They prevent mixing errors. Phenylephrine is packaged in concentra- tions that are 100 times stronger than what's needed for a typical dose. So to get it into a useable range, you need to do a double dilu- tion. In other words, you draw up the contents, dilute it down to 10 ccs, and then squirt out 9 of those ccs. And then you draw up another 10 ccs. But there's a lot of production pressure in ORs, and doing dilu- tion on the fly is risky. I can guarantee people occasionally fail to do the double dilution. I can also guarantee that it's a mistake that's way under-reported. Thankfully, pre-filled syringes that are already 100- fold diluted, which are what we use in my hospital system, eliminate the potential for that human error. 4. They reduce direct drug contamination. Accessing vials through a rubber lid while mixing in an open room is inherently riskier than mixing them under a hood in a clean room. 5. They reduce cross-contamination. Anesthesia providers often add drugs like phenylephrine and epinephrine to bags of saline to use as a dis- pensary over the course of the day, because it's so much easier that way. But what happens if someone gets confused and violates that supply bag with a syringe that was already used with another patient? That's much less likely with pre-filled single-use syringes. 6. They maintain consistent quality standards for safety and potency. Assuming, that is, you're using an FDA-approved 503B provider (see "Compounders are Stepping Up, Achieving Impressive Safety" on page 34). 5 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 1 6

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