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P A I N
M A N A G E M E N T
charged the patient. And then pain, an
• Closely track patients with peripheral
uninvited guest, sinks its hooks in and
nerve catheters. A nurse should call
makes itself at home.
pain pump patients on the night of
Here's advice from Dr. Siwek and
surgery and daily thereafter, says Dr.
others about how to
POST-OP PAIN MANAGEMENT
Siwek. "Let patients
manage pain so you
4 Indicators to Measure
know that they can
can achieve timely
• pain scores after surgery
return to your facility
discharges.
• pain scores at home
during business hours
• narcotic use at home
to get their catheter
1. Employ con• bounce-backs to the ER
evaluated, to get
tinuous
bloused or to get the
infusion pain pumps
catheter replaced, if necessary," he
Continuous peripheral nerve infusions
says. Also be sure to give patients the
appeal to Dr. Siwek because they pick
on-call anesthesiologist's contact
up where single-injection nerve blocks
information and to instruct patients
and other intraoperative efforts to con-
to disconnect the catheter or pump
trol pain leave off — at home, in the
when the infusion is finished, adds
hours and days after surgery and with-
Dr. Siwek. He notes that he places all
out the side effects of narcotic pain
of his nerve blocks and catheters pre-
relievers: abuse, addiction, even over-
operatively, with the patient fully
dose. "We're trying to avoid narcotic
monitored and sedated, under ultra-
use in the recovery room," he says,
sound guidance.
adding that he sends patients home
• Partner with a committed
with a prescription for a narcotic
vendor. Pick a vendor that will help you
painkiller to take as needed.
get your pain pump program off the
Patient education and vendor sup-
ground. "It's a huge endeavor to devel-
port are the pillars that support a suc-
op a pain pump program," says Dr.
cessful peripheral nerve catheter pro-
Siwek. "You want to have the kind of
gram, says Dr. Siwek.
support you need to do it." There are
many pumps on the market of varying
J U LY 2013 | S U P P L E M E N T
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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
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