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Dr. Sinha has also noticed a recent surge in the use of IV formulations of medications such as lido- caine, magnesium and ketamine. The increased use of ketamine makes sense given its benefits. "It's the only complete anesthetic we have in the sense that it causes analgesia, anesthesia and it does not depress respiration," says Dr. Sinha. The unique properties of ketamine make it an ideal medication for certain patients, particularly those with chronic pain or opioid issues. "It's the only anesthetic that works through the NMDA receptors," says Dr. Sinha. "All the other anesthetics work through the GABA receptors." Because ketamine suppresses NMDA receptors before surgical pain is felt, it has shown great effec- tiveness at preventing the "wind-up phenomenon" in at-risk patients, adds Dr. Sinha. • Patient education. While the exact amount of pain patients will feel following surgery varies greatly from person to person, this much is almost always true: They will experience at least some pain post-operatively. That's why it's critical for surgeons to manage patients' expectations about how they'll feel after surgery. "The first thing I recommend is beginning the conversation as early as possible," says Dr. Shaparin. "Patients need to understand that if they're having knee surgery, they'll be in pain — and we'll do our best to manage it as effectively and as safely as possible." The mindset in which patients enter the OR on the day of their surgery could ultimately play a role in their recovery, as well. Do everything you can to ease patients' anxiety about the procedure they're about to undergo. This means communicating early and often about everything they're likely to encounter during the surgical process; the earlier you communicate, the better. "If you're going to place a peripheral nerve block and the patient finds out only on the day of surgery that they'll have a needle stuck into / 0/ 00 /0 0/ 00 0 /0 0 / 00 0 00 0 0 00/ PY0 00/00 8 88 08 10 A DA 0 00 80 r 1 o r d e m /m v/ o g a .g da f w. w w p ep t R n en v Ev e s rs e v dv Ad r E e e w da v/ o -80 .g -FD -10 , U n , o io c e je n j ai ac va i p op Ro Ro v Inj ti n g t m 1 h ac Ea E h 1 n g s o D in ta it p sp o s e le gl n g in Si O e s Us s h i This U e Singl Hos 8 1 i L C Rev 000S Y 0 P P P 10) 190000( 17) ( 0036937498 01) (0 ( P Y 5 25 22 22 - 4- 24 22 -2 4- 4 84 - 1 2 72 1 9 29 SC , bia b lu o Co st e s n sio ns e te Ex . h t 2t 1 0 00 50 4 06-19-19 2672 C2 I CI C C 50 2 t n We C St m 2 7 8 4 224 222 0 00 00 00 /0 0/ 0 00 0 00 /0 0/ 0 S 0S 0 0/0 0 0/000 tch a w dw : g: ng tin rt o p rting .0 6. o 0 4. H; p aO Na l/ : HC s rs te s us ju dj .; p .s q P q S U S r o fo r ate Wa n in g; mg 6 8. P S U S e, de i d ri o lo h C m u iu di o ; S g; mg 2 P S U S tain l, Cl e n in ai e HCl, U P 2 m d g di m l ride, U P 8.6 mg; in W r f U P m 2 H adju r l/N e H 4.0 to 6 : s a C n o c L mL . n ditio n o d c n d h t e we e, s n t g patie n g s d u e n e mi e r de /O e o to be termin in nt's age, w ight, an . y ly n O e se Us e c ic fi ff l/ . e le sa e Re r o fo o No n o io rt o Po d e s us n Un d rd c s is . D r e n in n o Co e s os -D e ). F ) °F 7 ° 7 7 F °F 8 (6 C ° 5 2 5 C ° 0 2 0 e o r St e s U s s u s o n e v e r In or o No y. n ly O n tratio is in dm (6 u r Ep n d n St n f o r F o u g Dr de n u po mp o Co s is a C m d rug. For In n a 2 d E 2 nly. N C d D trav us U to filtratio S . Sto an re P pidu -2 ral A C ° -77°F o t fo e C tai r i ard U u at 2 d P rti n. N t f r R sal al ffi e Use l e ve a t va r e se e re p r a n ta n o t c o n s e o D s in a pr s va d 0 5 0 - 7 - 8 7 9 8 - 4 - 7 4 3 7 9 3 : 6 C : D N D ) L m / m g/ m 2 (2 L m 0 0 5 0 / 5 g/ 1 USP , on io t i nj In l C l HC e n in a i a c v a iv op Ro % 2 % 2 R iv acai HC In C i 1 g/5 0 (2 g/ N ject C 9374 987 5 tiv