Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
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ment issues can tax your facility resources — they may be worth the trouble. Recent studies have shown that the use of a continuous infu- sion of a local anesthetic is effective at reducing pain and opioid anal- gesic requirements, and aids in an earlier discharge for patients under- going upper or lower extremity procedures. The effectiveness of continuous nerve blocks can depend on your catheter system, although this is often left up to physician preference and facility budgets. While disposable, non-electronic infusion pain pumps are simple to operate and require less troubleshooting, their accuracy can change over time and may be affected by ambient tem- perature. There are also downsides to electronic pumps, since they can be cumbersome to operate and can have a short battery life. NSAIDs and acetaminophen In addition to regional and/or local anesthesia, you'll also want to con- sider some other components: namely, acetaminophen and NSAIDs. Acetaminophen is used to treat mild-to-moderate pain, but usually works best when combined with other analgesics. Acetaminophen can be used pre- and/or postoperatively, and comes in various forms including oral, rectal and IV. Recent studies suggest that IV acetamino- phen may provide a more rapid and effective analgesic effect com- pared to standard oral doses. The combination of acetaminophen and NSAIDs has been shown to offer superior analgesia compared to either one alone. NSAIDs reduce tissue swelling and muscle soreness and are often used alone to treat mild postoperative pain. However, clinical studies have shown that they're effective at treating moderate-to-severe pain when used in com- bination with other, more potent, non-opioid analgesics. Prescribing NSAIDs (and COX-2 inhibitors) for 3 to 4 days after ambulatory surgery — in combination with acetaminophen — can improve the recovery process and outcomes for your patients. One of the biggest concerns with NSAIDs is the possibility of gas- 5 4 O U T P A T 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 | A P R I L 2 0 1 5