Exparel is good standing alone in most patients if it's used properly.
Injection technique might not matter, but the size of the surgery and
patient selection are important. So is the current role of the preemptive
regional anesthesia technique.
Dr. Wagner Hopefully we achieve a better understanding of the neuro-
biology of pain. There are drugs in the pipeline that modify the neural
pathways of pain without involving opioid medications. A better
understanding of how the spinal cord processes pain will lead to spe-
cific targets for drugs that work at the spinal cord level. That's on the
10-year horizon.
Dr. Viscusi. I hope to see new products that are easier to use and more
cost-effective. We may see the emergence of opioids that have fewer
side effects than the current options. We may see other extended
duration local anesthetics with unique profiles. I'm hoping we'll see
new options among the NSAIDs. IV diclo-fenac was recently
approved and the available information looks promising.
Dr. Stamatos Neuromodulation in some form will be the next big jump
in pain control — figuring out a way to shut off pain input through the
spinal cord with non-medical means. OSM
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February 2015 | O U T PAT I E N TS U R G E R Y. N E T
The Holy Grail is to provide pain relief without
blocking patients' strength, to give them a sensory
block while leaving them with intact sensation.
— Philip Wagner, MD
E-mail dcook@outpatientsurgery.net.
