How opioid-free anesthesia can boost cases, reduce costs at ASCs: Q&A with Dr. Chhaya Patel

Time is money for ASCs, but patient care must always be the No. 1 priority. The use of opioid-free anesthesia can provide quality pain control while reducing postoperative complications for patients and allow for improved productivity for surgery centers, according to a study published in Urology in Pediatrics.

Chhaya Patel, MD, director of Satellite Boulevard Surgery Center in Duluth, Ga., spoke to Becker's ASC Review about the benefits of opioid-free anesthesia for patients and surgery centers.

Note: Responses were lightly edited for style and clarity.

Question: What is the significance of opioid-free anesthesia at an ambulatory surgery center?

Dr. Chhaya Patel: The national opioid epidemic has shed light on the role of opioid administration for surgery and its contribution to opioid abuse. It has been recognized that opioid use during surgery is a risk factor for future opioid misuse. Emerging data on the short- and long-term side effects of opioid administration for surgery has highlighted the importance of an opioid-free anesthetic regimen as an alternative to traditional practice. Opioid-free anesthesia is a multimodal technique that allows for a good quality of anesthesia and analgesia while obviating the need for opioids. There is good evidence that opioid-free anesthesia allows for quality pain control while reducing postoperative nausea and vomiting, allowing timely discharges and reducing opioid-related adverse events. As good stewards to our patients and to curb this opioid epidemic, we felt it was important to assess the opioids administered to our patients.  

Q: How does opioid-free anesthesia lead to greater productivity at an ASC?

CP: By using an opioid-free anesthesia, we were able to implement a fast-track technique in which we were able to bypass phase 1 of recovery, thereby saving money and improving efficiency. In a busy ASC, in which we perform 20 of these cases a day, this decrease in time leads to meaningful savings and an opportunity for increased cases each day. Opioid-free anesthesia at ASCs demonstrates increased efficiency, cost containment and an opportunity for greater productivity. It also led to increased satisfaction for the surgeons and families.   

Q: What are the challenges to implementing opioid-free anesthesia at a surgery center?

CP: Implementing a new protocol requires extensive education of the staff as well as periodic review of the impact on patient care and delivery of healthcare. We used the plan-do-study-act cycle as the systemic approach to implement this protocol and to review the quality of our patient care. The nurses and surgery center staff became comfortable as they noted the patients were comfortable, opioid requirement was negligible and family satisfaction score was at an all-time high.

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