Outpatient Surgery Magazine

Special Outpatient Surgery Edition - Hot Technology - April 2019

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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benefits," says Dr. Viscusi, "including cognitive preservation and ancil- lary anti-inflammatory effects. I think you're going to see ketamine coming back as a background infusion drug in a lot of anesthesia." • Intravenous lidocaine infusion is also promising. "There are a lot of data to support it," adds Dr. Viscusi. "It's a potent anti-inflammato- ry, and it appears to reduce the inflammatory response to surgery. It also seems to improve functional outcomes longer-term, even months after surgery." An intravenous version of the common NSAID meloxicam may also be FDA-approved by the time you read this (March 24 is the targeted approval date). It could provide a much faster onset of action and the potential for sustained analgesia. "Its once-daily IV dosing will appeal to many and will likely become a useful tool in our pain armamentarium," says anesthesiologist D. John Doyle, MD, of the Cleveland (Ohio) Clinic, before adding a cau- tionary note about its use with elderly patients and those at risk for renal injury. A combination of bupivacaine and meloxicam (HTX-011) is also in the pipeline and is designed to reduce inflammation and reverse the acidic environment caused by surgery, "allowing enhanced penetra- tion of bupivacaine into the nerves and thereby potentiating its effect." 2 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 1 9 We're still learning a lot about opioid-sparing techniques, because as a society we spent many decades using opioids as a crutch. — Mohammad Piracha, MD

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