Outpatient Surgery Magazine

Manager's Guide to Surgery's Ambulatory Anesthesia - July 2015

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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J U LY 2 0 1 5 O U T P A T I E N TS U R G E R Y. N E T 5 J u l y 2 0 1 5 | w w w . o u t p a t i e n t s u r g e r y . n e t A m b u l a t o r y A n e s t h e s i a C O N T E N T S 6 Which Drug is Better For Post-op Pain Control? Bupivacaine, at a price of about $2.80 per shot, or the liposomal bupivacaine formula- tion trade-named Exparel, at about $285 per vial? What we found may surprise you. Dan O'Connor | Editor-in-Chief 17 A New Way to Manage Post-op Pain The Perioperative Surgical Home model is revolutionizing patient care with preset clinical pathways for specific cases. Zeev Kain, MD, MBA 24 6 Things MH Experts Want You to Know The MHAUS hotline medical director answers your most pressing questions. Ron Litman, DO 30 4 Keys to a Sound Patient Warming Strategy Diminish the chilling impact of redistribution hypothermia. Jim Burger | Associate Editor 38 What Difficult Veins? Imaging technology all but guarantees first-stick success when starting IVs. Daniel Cook | Executive Editor 43 The Next-Generation Anesthesia Machines Technology updates make anesthesia deliv- ery safer for patients and easier for providers. Michael A. Olympio, MD 51 5 Keys to Managing Sleep Apnea Pre-op assessments and taking the proper precautions on the day of surgery will help keep these high-risk patients safe. Reginald F. Baugh, MD 57 How We Prevent PONV For at-risk patients, targeted interventions spell relief. Christopher A. Smith, CRNA, DNP 62 Does Your Anesthesia Service Make the Grade? Look for these qualities at the head of the OR table. Carrie L. Frederick, MD 67 The Gatekeepers of Ambulatory Surgery Q&A with Meena S. Desai, MD, an anesthe- sia society leader and patient safety advo- cate. 43 M a n a g e r ' s G u i d e t o To Our Readers It sounds like a great idea. Encapsulate bupivacaine in tiny bubbles made out of the same material as a cell membrane, and inject it into the muscles and soft tissues around the surgical wound. Like soap bubbles in a dishpan, these bubbles would burst slowly and predictably, releasing the pain-numbing medication over 72 hours for up to 3 days of pain control. That's the promise of Exparel (liposomal bupivacaine) from Pacira Pharmaceuticals. Turn the page to find out if Exparel, at $285 a bot- tle, is any better than $2.80 bupivacaine. We hope this and the other articles in the Manager's Guide to Ambulatory Anesthesia help you and your anesthesia providers optimize case outcomes and enhance the patient experience from pre-op to the PACU. Cover design by Ethan Anderson | Photo by Lynda Dowman-Simon, RN

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