Outpatient Surgery Magazine

Queasy Feeling - April 2017 - Subscribe to Outpatient Surgery Magazine

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/809919

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Page 7 of 154

More Questions Than Answers The correct path is not always lighted and marked. I n this issue, we ask a couple of provocative questions that are sure to start a good argument around the break table: • Are surgeons fueling the opioid epidemic? • Will OR dress code violations harm patients? While they're both rhetorical questions with arguments to be made for either side, they're also both highly inflammatory hot potatoes. Best to tread carefully, respectfully and armed with facts. Let's tackle post-op pain first. Short-term opioid exposure following surgery is now linked to risk of abuse, but to lay the blame for the nation's opioid addiction crisis at the feet of surgeons seems harsh. The surgeon's sin: overprescribing opioids for post-operative pain relief, writing for 50 painkillers when 5 or 15 will do. And in so doing, getting moms, dads and kids hooked on the euphoria they experience while on these highly addictive drugs. "Surgeons are unwittingly enablers of addiction, abuse and over- dosage," says noted surgeon and author Atul A. Gawande, MD, MPH, of Harvard Medical School, in this month's Annals of Surgery. What's a surgeon to do? Reduce pain and inflammation with non- opioids before, during and after surgery. Send patients home with regional blocks. And reduce opioid use after surgery. Yes, the multi- modal analgesia movement is in full effect. You can argue that inexpensive and readily available heroin is a major driver of the drug epidemic, but it's good to "raise patient awareness and help reset patient expectations," says Eugene Viscusi, MD, director of pain management at Thomas Jefferson University in Philadelphia, Pa. 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 1 7 Editor's Page Dan O'Connor

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