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P A I N
M A N A G E M E N T
lying cry for managing
you do the cases and
surgical pain.
get the patients out
Certainly something to
the door, but the
be more mindful of.
problem with singleinjection nerve
"We don't want
patients to call the doc
blocks is that they
at an outrageous time
wear off eventually,"
or to go to the emer-
says Dr. Siwek.
gency room for pain
"Then what? You
management," adds
either give patients a
Sandy Berreth, RN,
INFUSION RATES
BS, MM, CASC, admin-
My Pain Pump Protocol
lot of narcotics. Or
they bounce back to
the ER. I don't like
istrator for Brainerd
Lakes Surgery Center
For initial injection, all sites
to practice out-of-
in Brainerd, Minn.
20cc of 0.5% ropivacaine
sight, out-of-mind
medicine."
You're probably at
least somewhat famil-
For patients with
iar with the biggest
continuous infusions:
score while he's in
weapon in Dr. Siwek's
400cc of 0.2% ropivacaine in
PACU is one thing. A
arsenal to keep
volume pain pump, started in
patient's pain score
patients home once
PACU before discharge
while he's at home is
A patient's pain
something else alto-
they're discharged:
@ 4 to 6cc/hr for
Take-home pain
interscalene/supraclavicular
pumps that automati-
says Dr. Siwek,
starts when that
cally and continuously
@ 6cc/hr for infraclavicular
deliver a regulated
gether. The trouble,
upper extremity
interscalene block,
flow of local anesthet@ 8cc/hr for adductor canal
ic to a patient's surgical site.
for example, wears
off in 10 to 24 hours,
@ 8cc/hr for popliteal
"Nerve blocks let
long after you've dis-
— Don Siwek, MD
J U LY 2013 | S U P P L E M E N T
TO
O U T PAT I E N T S U R G E R Y M A G A Z I N E
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