Outpatient Surgery Magazine

Special Outpatient Surgery Edition - Anesthesia - July 2017

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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J U LY 2 0 1 7 O U T P A T I E N TS U R G E R Y. N E T 5 5 who are still unaware of alternative therapies — acetaminophen, IV NSAIDs, local anesthetics and gabapentin — that reduce the amount of opioids patients need. Physicians also tend to overprescribe opioids. They write scripts for 30 to 60 days of therapy when in reality most post-op pain improves after a week. Many patients don't finish their full prescriptions and the extra pills are left in medicine cabinets. That certainly contributes to the abuse potential. Isn't prescribing opioids easier than multi-modal pain management? That's true, to a degree. Physicians tend to overestimate how much pain medicine patients need after surgery and don't want to be bothered by patients complaining of discomfort. Instead of writing scripts for a week's worth of pain pills and requiring the patient to call in for refills as needed, they prescribe a longer regimen, regardless of whether it's needed. Is the outpatient evolution helping to limit the use of opioids? Absolutely. Providers must consider alternative non-opioid based therapies to provide pain relief without risk of PONV and sleepiness, so patients are ready for discharge hours after surgery. Several complex procedures are moving to the ambulatory setting and more could follow if we continue to develop analgesic options that don't cause significant side effects. OSM Dr. Gan (tong.gan@stonybrookmedicine.edu) is professor and chairman of the depart- ment of anesthesiology at Stony Brook (N.Y.) University.

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