Building an individualized plan comes down to an anesthesia
provider's awareness of a patient's history and preferences in addition
to the procedure's requirements. "It is incumbent upon anyone prac-
ticing anesthesia to have more than one way to do everything," says
Dr. Stanfield — not everyone will agree to regional anesthesia, for
example, due to a fear of needles or fears of paralysis — "and to
understand the tools and use them appropriately," even if that
involves administering opioids.
It's likewise important to understand what can and cannot be expect-
ed of multimodal modalities. For instance, he says, "people wrongly
conclude that regional anesthesia eliminates post-operative nausea and
vomiting. Maybe they're not aware that there are at least 8 discrete
causes of PONV, and that you're not going to eliminate PONV merely
by relying on regional anesthesia. As with most things in health care,
there are very few single-cause issues.
"It's up to us to try to identify the triggers in every patient and pro-
vide therapy that matches their individual profiles. Which is, admitted-
1 3 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 | M A Y 2 0 1 5
z JOINT EFFORT Regional blocks, in conjunction with non-
narcotic IV and oral analgesics, can unite against post-op pain.
John
A.
Scarfone,
Starfleet
Productions
