Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
Issue link: http://outpatientsurgery.uberflip.com/i/510361
1 5 9 M AY 2 0 1 5 | 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 It's reasonable to assume that any drug that affects perioperative inflammation is beneficial — especially if we believe that most adverse post-op outcomes are related to inflammation. While a stress response to surgery is important — it's how people recover — we also know that extreme abnormal responses can lead to gery and in all cases, POCD was significantly higher in the control groups. • California may recognize anesthesiologist assistants. Legislation recently intro- duced in California would make it the 18 th state to recognize "anesthesiologist assis- tants" — certified secondary providers who would be allowed to perform certain sup- port functions as well as assist in the development and implementation of anesthe- sia care plans for patients. Under the proposal, supervising anesthesiologists would still have to be "physically present" and "available to the assistant when medical services are being rendered" and would have to both oversee and accept responsi- bility for all services being rendered by the assistant. • Pacira blocked on Exparel. Pacira Pharmaceuticals continues to bump up against a wall in its efforts to have its long-acting analgesic, Exparel, approved as a nerve block. The FDA recently rejected the drug maker's application, forcing the company back to the lab again. Exparel, which has garnered favorable reviews as a surgical- site analgesic in hernia surgery and other cases, uses a time-release system to deliv- er bupivacaine for up to 3 days. In clinical trials, it's also shown promise as a femoral nerve block, but fallen short as an intercostal block. Pacira, which vows to press for- ward, has had an up-and-down history with Exparel. It was issued a warning letter by the FDA in 2014, accusing it of both overstating the drug's efficacy and of promoting indications for which it lacked FDA approval, including knee arthroplasty, lumbar fusion and gastric sleeve procedures. In response, Pacira claimed that its labeling supported the claims being challenged and that it would work with the FDA to resolve the issues. — Jim Burger