Dr. Martin.
The patients are also injected with liposomal bupivacaine, which
numbs the nerves along the incision and chest wall and lasts for 3 to 4
days post-op. "We used to give epidurals, which used narcotics, but
they didn't always work and required additional tubes and monitor-
ing," says Dr. Martin. "Then we were having to come up with alterna-
tive ways to manage the patient's pain." They do rib blocks now,
numbing up anywhere there will be an incision or a drain.
After surgery, the patients are kept on regular doses of the non-opi-
oid medications they were given before surgery. This serves as their
baseline and keeps them comfortable when they are discharged —
which happens much faster now, says Dr. Martin. "Patients would
much rather recover at home than in the hospital," she explains. "But
we're not discharging them before they're ready. We've given them the
education they need to recover at home confidently. The whole pur-
pose of the patient education is to reduce the physiological and men-
tal stress of surgery by knowing what to expect. The unknown is
much scarier than the known. So even if the known isn't fantastic —
for instance that they're having cancer surgery — it's still better than
the unknown."
The combination of patient education and multimodal pain management
is a strong team-up in the fight against the opioid epidemic.
OSM
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