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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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1. Ultrasound-guided nerve blocks Gregory Hickman, MD, medical director and director of anesthesia at the Andrews Institute Ambulatory Surgery Center in Gulf Breeze, Fla., says regional anesthesia is becoming the go-to treatment for post-op pain in more and more facilities. "In the last 10 years, that's really the cornerstone of what has been growing and what's continuing to grow in popularity," he says. "There are a lot of places that are just now get- ting on board." Placing nerve blocks, whether single-shot or continuous, is an effec- tive way to handle painful extremity procedures like knee replace- ments and shoulder surgery, says Dr. Settles. "Using a nerve stimula- tor or, more and more frequently, ultrasound, you can get near the nerve where the surgery is going to take place, inject a local anesthet- ic and quiet the pain signals before they even start imprinting on the patient's brain," she says. "Being ahead of it provides a big impact for lessening the pain post-operatively." Part of what is driving the trend is improved equipment, says Dr. Hickman. Innovations like easy-to-use catheters and echogenic needles — which are better visualized under ultrasound — make it simpler for your anesthesia providers to place the blocks. But, by far, the biggest factor driving the increase of regional blocks is the use of ultrasound, says Dr. Hickman. The latest ultrasound devices are smaller and con- tain features like high-definition imaging and touchscreen interfaces. They're also becoming more affordable. And the technology is only going to improve in the future. Dr. Hickman notes that manufacturers are currently working on adding features like wireless probes and soft- ware that could transform your mobile phone or tablet into an ultra- sound device, an ideal option for small facilities who want to boost their regional programs. 2. Improved pain pumps 4 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 • A P R I L 2 0 1 6

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