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The Economics of Prefilled Syringes - August 2017 - 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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patients by giving them 1 to 2 sublingual tablets containing midazo- lam, ketamine and an antiemetic. Ms. Dillon's staff and surgeons tri- aled the tablets, but decided against using them. "Sometimes 1 tablet wasn't enough, and 2 were too many," says Ms. Dillon. "We found that it took patients longer than the typical 10 to 15 minutes to recover after surgery." The bigger issue is that the tablets are controlled substances that need to be refrigerated. "We had to figure out a way to double-lock the medications in a refrigerator," says Ms. Dillon, who ended up storing the tablets in a small safe placed in a refrigerator, which had French handles she could secure with a bike lock. "Those are things you don't think about." • Pupil maintenance. Roughly two-thirds (63%) of respondents say their surgeons use mechanical devices — Malyugin rings and iris hooks, for example — in less than 5% of cataract cases to maintain pupil size in patients who are difficult to dilate. The survey also shows that 45% of respondents say their surgeons use pharmaceuti- cal pupillary dilations methods in less than 5% of cataract cases. However, one-third say their surgeons use the drugs in more than 20% of cases. Ms. Dillon's surgeons trialed a pupillary dilation medication, but found it wasn't overly helpful and was also cost-prohibitive, even though her facility could apply for reimbursement. "If I'm paying $460 per case and waiting to be reimbursed, surgeons will see their divi- dends dwindle until that reimbursement comes back," says Ms. Dillon. Pharmaceutical options for keeping pupils dilated were too expensive for the ASC of Niagara, says Ms. Zimdahl, so surgeons there now choose between epi-Shugarcaine ($26 per case), Malyugin rings and iris retrac- tors ($100-plus per case). • Improved refractive outcomes. Promising patients that their 7 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 U G U S T 2 0 1 7

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