physical activity.
• Get buy-in. Set realistic expectations with
patients about the pain-relieving measures you'll
implement and ensure that the messaging aligns
with the efforts of providers along the continuum
of care, suggests Elizabeth Wick, MD. "For
instance, surgeons tend to be hesitant about using
NSAIDs because of a perceived increased risk of
post-op bleeding, but, in reality, this risk is very
low," says Dr. Wick, a professor of surgery at
University of California San Francisco. "Providers
need to gain consensus around multimodal analge-
sia for all eligible patients."
Evolving movement
ERAS pathways ensure optimal pain-relieving prac-
tices are provided to all patients, according to Dr.
Wick. "The protocols encompass evidence-based
processes," she says. "They provide a terrific frame-
work for helping surgical professionals provide con-
sistent care. Every patient can benefit from stan-
dardized pain control practices — simple cases
require simple protocols, and more complex cases
demand more comprehensive pathways."
Multidisciplinary efforts that help patients recov-
er from surgery are becoming more important as
complex procedures continue to move to the outpa-
tient setting, points out Dr. Wick. "All patients
should be treated with ERAS principles and with a
standardized, team-based approach," she says.
More providers are buying into ERAS proto-
cols and care teams are understanding the impor-
tance of performing them well and consistently,
but Dr. Wick believes ensuring every patient
receives enhanced care continues to be a chal-
lenge. "It requires close partnership among a
team of diverse providers, and it needs to be
worked at and supported," she says. "Ultimately,
it's a worthwhile journey."
OSM
M
A R C H 2 0 2 1 • O U T P A T I E N T S U R G E R Y . N E T • 1 3
For a free sample or more information visit
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Echogenic brightness,
even at angles greater
than 45 degrees
CHOOSE PORTEX
®
ECHOGLO
®
AS PART OF
YOUR ERAS STRATEGY
TO REDUCE OPIOID USE1
Portex® EchoGlo® Peripheral
Nerve Block Solutions
Ultrasound guidance is emerging as the standard of
care in regional anesthesia and is consistently
reported to improve accuracy and safety in both adults
and children.
1,2
EchoGlo
®
catheters are echogenic from tip to tip,
allowing you to visualize the location of your
catheter using ultrasound at the time of insertion
and during use.
> 45°
1. Valdivieso, Ronald MD. "Peripheral Nerve Blocks." Anesthesia Secrets, 4th Ed., 2011, pp.
466-471
2. Focused Cardiac Ultrasound for the Regional Anesthesiologist and Pain Specialist, Stephen C
Haskins, Regional Anesthesia Pain Med Sep/Oct 2017;42(5)632-644
3. Ultrasound-Guided Regional Anesthesia, Manoj K. Karmakar A Practice of Anesthesia for
Infants and Children 6th Edition 2019, pg. 988-1022.e4
Please see the Instructions for Use for a complete listing of indications, contraindications,
warnings and precautions. Portex, EchoGlo and the Smiths Medical design mark are
trademarks of Smiths Medical. ©2021 Smiths Medical. All rights reserved.
Implementing ERAS protocols
requires disrupting 'the way it has
always been done' mentality.