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apnea."
You're probably familiar with the patient who is snoring one minute and
requesting medication for horrible pain the next. "Without any interven-
tion, the patient is back to sleep within a minute," says Janice J. Izlar,
CRNA, DNAP, of the Georgia Institute for Plastic Surgery in Savannah, Ga.
Patrick McCarty, DDS, of McCarty Anesthesiology in Boston, Mass., says it's a
struggle to get surgeons on board with the appropriate choice of local.
Non-opioid paradigm shift
For a growing number of surgical facilities, the newer non-opioids, like Exparel
(bupivacaine liposome injectable suspension) and Ofirmev (IV acetamino-
phen), have become the foundations of their multimodal analgesia regimens. "I
find that the newer non-opioids are best utilized in a pre-emptive analgesic
strategy," says Dr.
DeFrancesco. "They are
extremely useful if given
early, before incision,
and can significantly
decrease post-op opioid
requirements."
Exparel and Ofirmev
have also reversed the
order of drugs anesthe-
sia providers administer
to control post-op pain.
Rather than starting with
opioids, those who use
Exparel or Ofirmev use
these non-opioids first,
and then layer on
P O S T - O P E R A T I V E P A I N
EXP-AP-0020-201301
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