FDA updates opioid prescribing information
Editor's Note The Food and Drug Administration (FDA), on April 13, updated prescribing information for all opioid pain medications, including requiring all packaging to have updated labeling and safety information. This includes stating that: for both immediate-release (IR) and extended release/long acting (ER/LA) opioid pain medications, the risk of overdose…
Reducing opioids prescribed after total joints
Editor's Note This study from the University of Michigan, Ann Arbor, finds that total hip (THA) and total knee (TKA) arthroplasty patients could be prescribed less opioids after surgery without the need for refills. The analysis included a cohort of 120,889 opioid-naïve primary total joint arthroplasty patients aged 18 to…
Comparison of postop opioids prescribed by APCs vs surgeons
Editor's Note This study from the University of Michigan Medical School, Ann Arbor, finds that postoperative opioid prescriptions written by advanced practice clinicians (APCs), defined as nurse practitioners and physician assistants, had higher total dosages compared with those written by surgeons. A total of 628,197 surgical procedures involving 581,387 adults…
Contrast media shortage reveals cracks in supply chain
May 2022 saw a critical shortage of the iodinated contrast medium (ICM) iohexol that extended well into June because of a COVID-19-related shutdown of a GE Healthcare plant in Shanghai, China, that interrupted the manufacture of ICM. According to the American College of Radiology, contrast media were added to the…
ASA: Best practices to manage acute pain in surgical patients developed at pain summit
Editor's Note The American Society of Anesthesiologists (ASA) announced on March 8 that it had joined with 14 leading medical specialty organizations to establish seven guiding principles to address the treatment of acute perioperative pain in complex surgical patients. The new principles were developed during a second landmark pain summit…
COVID-19 driving the move to regional anesthesia
Cancellations of some surgical procedures during the COVID-19 pandemic and case rescheduling have been a major focus for perioperative leaders. But changes are also occurring in anesthesia practices. For many surgical procedures, the use of regional anesthesia or nerve blocks, coupled with light sedation, is reported to double if the…
Effect of duloxetine on opioid use after TKA
Editor's Note Duloxetine was found to be better than placebo for reducing opioid use and was of equal efficacy to placebo for reducing pain after total knee arthroplasty (TKA), in this study presented at the American Society of Regional Anesthesia and Pain Medicine annual meeting, May 13, in Orlando, Florida.…
Study: Postop opioid prescriptions decreasing, but not to recommended levels
Editor's Note Opioids prescribed after outpatient surgery are going down, but still do not meet expert recommendations, a new study from Epic Health Research Network finds. The researchers examined the median number of opioid tablets prescribed after outpatient surgical procedures between January 2017 and December 2020. For four orthopedic procedures,…
Joint Commission approves four new EPs for office-based surgery
Editor's Note The Joint Commission, on January 13, announced that it had approved four new elements of performance (EPs) for office-based surgery practices that prescribe medication. The EPs for Medication Management Standard MM.04.01.01, which will become effective July 1, address the following: Having a written policy that identifies specific medication…
Patient-preference playlists improve pre- and postop experiences
Streaming music apps and access to music through smartphones and similar devices make it easy to provide many different genres of music and modalities that can ease surgical patients’ fears. The use of music in both pre- and postoperative settings has been extensively researched, but less is known about how…
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