Some practitioners habitually prescribe opioids, the consequences in America are now described as a national crisis. Essentially the focus here is “better opioid stewardship” and a “move away from the traditional fundamental principle of opioids first”.
Presented by Michael Manning, MD, PhD, Assistant Professor at Duke University Medical Center, Director of Research for the Perioperative Medicine Fellowship at Duke.
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As a forward thinking anesthesiologist, I’ve given opioid free anesthesia since March 26, 1992. none of the >5K patients were admitted for wither pain or PONV, the two most common causes of unanticipated causes. No opioid addicts or overdose deaths. All patients discharged to home without professional aftercare givers. Incremental propofol induction.maintenance followed by 50 mg IV ketamine 2-5′ pre-subcutaneous local analgesia injection was the basis for this extraordinary success. The addition of real time EMG/BIS brain monitoring made this simple paradigm numerically reproducible.