Concept of the Ambulatory Pain Physician

This article explores the crucial role that a dedicated pain physician would have in the ambulatory surgery setting.Recent FindingsThe prevalence of chronic pain, opioid use, and substance abuse is growing in this country, while ambulatory and same-day surgery have also experienced considerable growth. Inevitably, more patients with challenging chronic pain or substance abuse are having ambulatory surgery. Increased BMI, advanced age, more comorbidities warranting a higher ASA physical status classification, and longer surgeries are now all components of ambulatory surgery that contribute to increased risk too. Certain surgeries including breast surgery, inguinal hernia repair, and thoracotomy are at higher risk for the conversion of acute to chronic pain, and an ambulatory pain specialist would be beneficial for added focus on these patients.SummaryMultimodal pain control with non-opioids and regional anesthesia adjuvants are beneficial, while emphasis on a patient ’s functional capacity may be more useful than quantifying the severity of pain. Despite the best efforts of patients’ primary care providers or surgeons, patients often are discharged with more chronic opioid therapy than they presented with, and an ambulatory pain specialist can help manage th e complications and prevent further escalation of this opioid epidemic. An onsite anesthesiologist with interest in pain management in each ambulatory surgery center administering anesthesia and available onsite to dea...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research