Outpatient Surgery Magazine

OR Excellence Awards 2016 - September 2016 - Subscribe to 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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plane blocks for laparoscopic procedures, colon surgeries and hernia repairs," says Dr. Langton, adding that those are typically accompa- nied by injections of liposomal bupivacaine that provide up to 72 hours of analgesia. Of course a few skeptical patients, having had the concept behind regional blocks explained to them for the first time, cock their eye- brows and decide they'll pass, says Ms. Rackers. "They're a little leery because it's a new thing," she says. They decide on more traditional approaches instead. And then the pain begins to kick in, and they sometimes change their minds. 5 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • S E P T E M B E R 2 0 1 6 Plastic surgeon Matthew Schulman, MD, has reduced opioid use in his New York, N.Y., facility with a multimodal approach that incorporates pre-operative, intra-oper- ative and post-operative analgesia. Patients receive 1,000 mg of acetaminophen imme- diately before they're brought into the OR. After induction, lidocaine is injected into the surgical area, which reduces the need for opioids. Then, during surgery, liposomal bupivacaine is injected around the site, which functions as a field and nerve block, sometimes providing up to 3 days of pain control. Once awake, patients get another 500 mg of acetaminophen and 220 mg of naprox- en orally. As a result of the regimen, patients rarely require more than 10 mcg of fentanyl in the recovery room, says Dr. Schulman, and they have less nausea, so they mobilize and recover faster. QUICK RECOVERIES Multimodal Regimen Fuels Speedy Discharge • READY FOR DISCHARGE Patients rarely require more than 10mcg of fentanyl in the recovery room. Awards Issue

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