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A Deep Dive Into Surface Disinfection - October 2017 - 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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1 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 • O C T O B E R 2 0 1 7 A Day of Surgeries and Zero Opioids Will alternative pain management techniques go mainstream? Y ou hear so much nowadays about opi- oid-free anesthesia, but how do you go from Demerol and Dilaudid to Celebrex and Cymbalta? Can you really manage your patient's surgical pain with regional blocks and beta blockers? How do you substitute keta- mine, precedex or clonidine for fentanyl in the OR, and NSAIDs for narcotics in PACU? How do you not send patients home with a pre- scription for (too many) painkillers? The Society for Opioid Free Anesthesia (SOFA) is glad you asked. The 200-member fledgling group (goopioidfree.com) is educating anesthe- sia providers and sponsoring research about opioid-free techniques, spreading the word that patients will do just fine without opioids during and after surgery. "It was not my intention starting out to totally get rid of opioids from my anesthetic practice," says SOFA's founder, Tom Baribeault, CRNA, MSN, of Richmond, Ky. "I started looking at ways to limit opioids both intraoperatively and post-operatively. As I added different drugs and different techniques, the amount of opioids I was using got to be so small, I started asking myself, 'Why am I still giving them?'" The last opioid standing? Fentanyl. When he withheld the fairly sizable dose of fentanyl he always gave in tandem with propofol, patients didn't even miss it. "What was shocking to me is that patients did even better when I took out the fentanyl," says the 36-year-old Mr. Baribeault. "They had less pain, less nausea and they breathed better. One of the big dangers of opioids is that they depress a patient's drive to breathe. When com- Editor's Page Dan O'Connor SOFA's founder, Tom Baribeault, CRNA, MSN

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