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O R T H O P E D I C S
place the knee platform's components through an incision approximately 9cm long.
Managing pain and complications
Patients must be medically stable, comfortable and ambulatory without assistance before being sent home. Managing their pain and PONV
and DVT risks achieve those goals.
• Pain. People have different pain tolerances, so we tailor pain control
medications to each patient, toeing the fine line between making them
comfortable and keeping them alert enough to ambulate after surgery
and recover quickly enough for timely discharges. We assess patients
before, during and after procedures to determine the minimal pain medication needed to get them through surgery comfortably and efficiently.
The goal is to tailor doses so that we control discomfort and they're
ready to start moving on their own shortly after surgery.
Most patients take 10mg of oxycodone twice a day, tapered over 5
days post-op. They're also given acetaminophen and hydrocodone for
breakthrough pain. Patients who are more sensitive to pain, haven't
responded to those medications, already take pain medications or are
heavy drinkers, receive stronger doses of oxycodone, typically
between 20mg and 30mg. We give patients who'll receive oxycodone
after surgery a dose in pre-op and PACU to preemptively attack pain.
Preemptive medication is always better than reactive medication —
you want to prevent pain, not treat it.
• PONV. Controlling pain and preventing PONV are interrelated with
minimally invasive surgical techniques and light sedation. Patients
who undergo minimally invasive surgery typically require smaller pain
medication doses, which means PONV is less of an issue. Patients
who aren't nauseated or hypotensive, who aren't spaced out on pain
medications, are able to walk sooner after surgery and more likely to
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | J U N E 2013
