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P A I N
M A N A G E M E N T
• Opioid consumption. Through post-op day 3, narcotic use was 33% of
expected, with patients provided 30 tablets for use during the study.
• Quality-of-life impact and opioid-related symptom distress. Measured
using the Overall Benefit of Analgesic Score (OBAS), which has a
scale of 0 to 24, patients reported an average <4.0, indicating a high
overall benefit.
• Patient satisfaction. All patients reported >3 on the 0 to 4 Likert scale,
indicating high satisfaction.
"Exparel lets surgeons treat pain directly at the surgical site with a
single-dose injection for up to 72 hours, when post-op pain is at its
worst," says Dr. Finical. "Using non-opioid adjunctive therapies for pain
control lets us reserve opioids for rescue situations where breakthrough
pain cannot otherwise be controlled. This means we can minimize use
of pain medicines that can be addictive or come with other unwanted
— Stephanie Wasek
side effects."
action to create synergistic pain relief with fewer side effects. The goal
is to use at least 2 non-opioid agents, using opioids only as adjunctive
agents, as much as possible. Minimizing opioids will result in a reduction of opioid-related side effects, fewer analgesic gaps, less dynamic
pain, improved long-term outcomes, better functional post-op recovery
and improved patient satisfaction. Your non-opioid arsenal:
• NSAIDs. NSAIDs are very safe, except in a few cases (patients with
significant renal disease or known GI bleeding). NSAIDs block the
effects of the enzymes Cox-1 and Cox-2, effectively keeping down
swelling (inflammatory pain) and relieving nociceptive pain at rest
and during movement. Compared to opioids, NSAIDs are much more
effective at reducing pain. Opioids result in spikes in pain, whereas
NSAIDs provide longer-lasting relief of rest and movement pain.
J U N E 2013 | 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
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