proximity of the
major nerves," says
Anis Dizdarevic, MD,
director of regional
anesthesia and acute
pain medicine at
Montefiore Medical
Center in the Bronx,
N.Y. "Instead of using
the local anesthetic,
you apply the elec-
trodes, leave them
subcutaneously
inserted, and then
you stimulate the
area. It's definitely a
promising technolo-
gy. I see it being used
more in the future for acute pain management."
• Intraoperative pain monitors. Dr. Disdarevic is excited about
the possibility of objectively measuring a patient's pain in real
time in the OR using pain monitors that process EEG signals dur-
ing surgery and produce an analgesia nociception index, or noci-
ception level index. "We're working on designing different algo-
rithms that will use some EEG activities, but also sympathetic
and parasympathetic systems of the body during surgery," he
says. "We want to see if we can extrapolate that to get some
sense of how much pain the patient is experiencing. We can use
that as a guide to provide additional analgesia if needed." While
not yet in use at Montefiore, Dr. Dizdarevic expects more
M A Y 2 0 2 0 • O U T PA T I E N T S U R G E R Y. N E T • 6 1
• LET'S TALK A holistic approach to post-op pain management requires patient
engagement, education and communication in advance of surgery.
