wall, you can effec-
tively, through a sin-
gle injection site,
cover multiple nerves
that are providing
sensation to that larg-
er area," he adds.
Patients want personalized care
As it becomes more multimodal, pain management is becoming
more personalized. Factors like the type of surgery combine with
individual patient traits like preoperative and chronic pain levels,
relevant comorbidities, and health status and history, including
anxiety and mood disorders. Non-opioid prescriptions and OTC
medications like ibuprofen, acetaminophen and aspirin, along with
heating pads, ice packs, and non-medication techniques like medi-
tation, are being mixed and matched to develop individualized pain
management plans.
Preoperative patient assessment is key. Dr. Dickerson uses pre-
scription monitoring databases to see what a patient has been pre-
scribed, what they're filling and who prescribed them medications
— rather than relying on the patient's recollection or willingness to
share. "We better know who the patient is based on the medica-
tions that have been dispensed, what kind of risks they might have
and what their care needs might be," says Dr. Dickerson. "And we
can see who else is managing their pain." That allows for collabo-
ration between providers for more consistent care and monitoring,
and evaluation of potential drug-drug interactions.
"We're moving toward a shared decision-making landscape with
patients," says Dr. Dickerson. "We're trying to find ways to give
M A R C H 2 0 2 0 • O U T PA T I E N T S U R G E R Y. N E T • 5 1
It's far cheaper to give a single dose of
sufentanil to get patients comfortable so
they can go home than it is to keep them
for another hour in the recovery room.
— David Dickerson, MD
