If surgeons believe patients will require more than a 7-day supply of
opioids, they must fill out and sign a separate form acknowledging
that they educated patients about the risks of taking an extended
course of opioids and list on the form the medical conditions necessi-
tating more than a week's supply of the painkillers. The form remains
with patients' charts on the day of surgery and is added to their med-
ical records.
"We've realized that our team plays a crucial role in educating
patients about alternative pain control options," says Ms. Rowe. "We
explain that they don't have to take opioids to find relief from post-op
pain. There are other effective methods."
Always striving
Lakeside's anesthesia providers, surgeons and nursing staff stay cur-
rent on pain management research and constantly work to incorpo-
rate the latest developments into their protocols and practices. For
example, they're reevaluating the benefits of using IV NSAIDs to
reduce tissue inflammation based on what the center's anesthesiolo-
gist medical director heard at a national conference. Additionally, the
team recently took steps to enhance its pain management protocols.
Now, in pre-op, patients receive:
• Tylenol 1,000 mg IV
• Celebrex, per surgeon request
• Neurontin 300 mg to 600 mg PO
• Valium 5 mg PO
During surgery, they receive:
• Ketamine 0.5mg/kg prior to incision (an additional ketamine dose
of 0.25mg/kg is given 1 hour later if it will be at least 45 minutes
before the anticipated time of emergence from anesthesia
In post-op, they receive:
5 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • S E P T E M B E R 2 0 1 9