6 0
O U T P AT 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 | O C T O B E R 2 0 1 4
ery with it.
Or, the source of her pain could be identified and temporarily
treated. "A lot of times what chronic pain management is, is a
decision pathway," he says. An understanding of the mechanics of
pain, of neuropathic causes and effects and not just anesthesia's
traditional focus on surgical pain, can open your clinical options.
He administered a bilateral transversus abdominis plane (TAP)
block and the patient's pain receded. It was a temporary solution,
of course: a more lasting fix would require the ablation of the
nerve roots responsible for the pain signals, but "it got us through
surgery," he says. "I don't know how long it lasted. At least a day,
because when we called her, she was still feeling good."
Mr. MacKinnon admits it was an unusual situation. Almost all of
the blocks he places
in pre-op are intend-
ed to support post-op
pain management,
and for outpatient
pain management
services he generally
employs lumbar
steroid injections.
"That's the first time I
ever saw something
like that, and I don't
expect to see it
again," he says. Like
all nerve blocks, it
generated no income
for the facility and its
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DELAYS
RETURNS TO
SURGERY
TRANSFER TO
HOSPITAL
POST-OP
PAIN
POST D/C
CARE
PAIN AT
HOME
PERCEIVED
EXCELLENCE
100
90
80
70
60
50
40
30
20
10
0
Complication Delays Returns Transfer Post-Op Post D/C Pain at Perceived
to Surgery to Hospital Pain Care Home Excellence
Benchmark 2.3% 4.8% 0.8% 1.2% 7.8% 99.4% 62.5% 89.9%
Your Center 1.0% 0.0% 0.0% 1.0% 5.5% 100.0% 72.8% 95.2%
Procedure-Specific Benchmarking
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