Outpatient Surgery Magazine

Special Outpatient Surgery Edition - Orthopedics - August 2018

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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Page 22 of 86

matory drug (NSAID), acetaminophen, an anti-anxiety medication and oxycodone. We give dexamethasone intraoperatively to help control pain and prevent nausea. We usually discontinue opioids by the first follow-up visit at 2 weeks post-op. Some studies suggest that the anterior approach might result in more blood loss than the posterior approach, but I think that's dependent on the experience of the surgeon. I've done more than 500 hip replacements with the anterior approach in the outpatient setting, and have had to transfer only 1 patient to the hospital on the day after surgery because of symptomatic blood loss and anemia. We do a couple of things to minimize the risk that patients will have asymptomatic anemia post-operatively. First, if patients are anemic pre-operatively, we determine why they are and consider ways to cor- rect it, such as by giving them iron supplements. They might also have an occult GI bleed that needs to be treated. Second, we give oral tranexamic acid, a medicine that helps with clotting, to all patients before surgery. Spinal anesthesia also lets us maintain a lower blood pressure, which results in less bleeding. We also use hemostatic devices to help minimize blood loss. No looking back In our 5-year experience with anterior-approach total hip replacement, we've had low complication rates, high patient satisfaction and signifi- cant cost savings. If your surgeons and your facility are properly pre- pared and your patients carefully selected, outpatient total hips are a win for everyone involved. OSM A U G U S T 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 2 3 Dr. Toy (ptoy@campbellclinic.com) specializes in joint replacement and sports medicine at Campbell Clinic Orthopaedics in Memphis, Tenn.

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