Outpatient Surgery Magazine - Subscribers

Surgical Smoke Nearly Killed Me - Outpatient Surgery Magazine - February 2018

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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Page 87 of 128

X-ray processing machine or a C-arm, which can be both expensive and difficult to store. Your center should decide whether the invest- ment is cost-effective for your facility. Templating orthopedic proce- dures will save you an enormous amount of time in the OR, as you'll know the right implant — often within 2 mm of the implant you end up using — and where to make your cuts 3 Non-opioid pain control Managing a patient's pain is a huge part of making your total hip procedures more efficient, especially in an outpatient set- ting. The less pain a patient feels following a surgery, the more ready he is to return home within hours. However, I try to avoid opioids like hydrocodone and oxycodone and instead give my patients tramadol for breakthrough pain. I've found that opioids are not entirely necessary for hip replacements, and that tramadol acts as a more moderate, non-narcotic pain reliever. For my practice, pain management starts in the office when I meet with patients for a consultation day around 2 to 3 months before their procedures. I ask each total hip patient what medications he's current- ly taking for pain, to rank his pain on a 1-10 scale and I ask whether his medication helps reduce that pain. Those simple pre-operative questions can give you a strong sense of how to handle your patient's pain following the procedure. For example, if a patient ranks his hip pain as a 7 and says that ibuprofen controls that pain, I'll suggest he continue taking ibuprofen — rather than a prescription painkiller — following the procedure. I've found that whatever the patient takes for his hip pain before the operation generally controls his post-op pain as well. On the day of surgery, we give patients several preemptive pain medications, including 1 g of acetaminophen and 400 mg of celecoxib, 8 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 • F E B R U A R U Y 2 0 1 8

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