Archive June 2019 XX, No. 6

Post-op Pain Pearls

A review of strategies and studies on managing surgical pain.

Dale Burleson, MD


OPIOID-SPARING Results from a pilot study performed at the University of Michigan showed that more than half of patients used no opioids after their operations — and almost all of the patients reported their pain was manageable.

If your anesthesia providers rely on inhaled anesthetics and opioids, they're behind the times. As Gary Lawson, MD, says: "I used to knock out patients. Now I knock out nerves." His email is, but Dr. Lawson, chief anesthesiologist of the Surgery Center of Naples (Fla.), has all but hung up his mask. He prefers to do his cases under regional anesthesia, which often obviates the need for opioids.

"We will knock out any part of the body that we can as opposed to general. That's what we like to do and we've trained all our providers to do," says Dr. Lawson, president of Quantum Anesthesia, which places 10 CRNAs and 5 physician-anesthesiologists throughout Florida.

The maxim — general never fails but regional is iffy — no longer holds true, says Dr. Lawson. It helps that he no longer relies on anatomical landmarks and patient cooperation to place blocks. Now he places blocks with the precision of dual guidance: nerve stimulation and high-resolution ultrasound.

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