Pre-op analgesia makes the difference at the Texas Health Women's Specialty Surgery Center in Dallas.
The name of the game today is multimodal post-surgical pain management. Playing an increasingly important role in this regimen are non-opioid analgesics. The leaders in this category are long-lasting Exparel (bupivacaine liposome injectable suspension), encapsulated in DepoFoam, a proprietary technology that lets Exparel's analgesic effects last much longer than the standard 6 to 8 hours, as well as injectable ibuprofen (Caldolor) and injectable acetaminophen (Ofirmev). Non-opioid analgesics result in shorter stays, reduced costs and less opioid consumption and, of course, less opioid-related adverse events. As important, they effectively control pain.
"One of the greatest hurdles in outpatient surgery is the fact that post-operative pain needs to be controlled before the patient can be discharged," says Vicki V. Schultz, RN, CASC, president of the Texas Health Women's Specialty Surgery Center in Dallas.
And controlling pain without using narcotics can be especially challenging when it comes to procedures such as laparoscopic hysterectomies, laparoscopic cholecystectomies and thyroidectomies, says Ms. Schultz. But in addition to other concerns, narcotics can cause PONV, increased drowsiness and urine retention, all of which can significantly delay discharge.
"After several studies on pain control, we have found the best method to decrease narcotic usage is preemptive analgesia," says Ms. Schultz. Additionally, surgeons at the center inject a local anesthetic at the incision site. The combination has resulted in a marked reduction in post-op pain.
"We've also noticed that post-operative patients are ambulating sooner, experiencing much less urinary retention and having less nausea," says Ms. Schultz.
"Our No. 1 goal is our patient's comfort and care," she adds. "Preemptive analgesia has made all the difference in our patients' ability to progress through the outpatient surgical process with as little pain as possible."
OR Excellence award winner, Pain Management... show all keywords
OR Excellence award winner, Pain Management
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