says Dr. Viscusi. "In
fact, the data now
strongly show that
opioids are not the
most powerful anal-
gesic agent. There
are a lot of drugs
that are on par in
terms of efficacy."
The quest for per-
fect pain manage-
ment, or something
as close as possible
to perfection, con-
tinues, fueled by the overlap of art and science.
"We're still learning a lot about opioid-sparing techniques, because
as a society we spent many decades using opioids as a crutch," says
Mohammad Piracha, MD, an anesthesiologist and pain management
specialist at Weill Cornell and the Center for Comprehensive Spine
Care in New York City. "We've forgotten about some other medica-
tions that are supremely effective. There are so many classes of med-
ications that have gone by the wayside, because there was such a
surge of opioid use. I think some people are starting to look back and
say, you know what, this medication used to work great."
Medications like these:
• Ketamine, which was recently FDA-approved as a nasal spray to
treat depression, is also showing considerable promise as an anesthet-
ic agent.
"There's a host of emerging data supporting ketamine as not only
reducing tolerance and hyperalgesia, but also providing a lot of other
A P R I L 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 2 1
• PUSHING FORWARD New IV NSAIDs in the pipeline promise to give providers even
more opioid-sparing options to manage post-op pain.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
