Orthopedic surgeon Evan Argintar, MD, performs dozens of narcotic-free surgeries in the Washington, D.C., area, and is a former a former assistant team physician for both the NBA's Washington Wizards and MLB's Washington Nationals. Becker's ASC Review interviewed Dr. Argintar about the pain management trends affecting ASCs.
Note: Responses have been edited for style and clarity.
Question: What are the trends and innovations impacting pain management in ASCs?
Dr. Evan Argintar: As ASCs become more popular and available, trends are moving toward doing all elective surgeries in the centers, and even larger surgeries that have historically been inpatient. This includes hip and knee replacement. As innovations in pain management have improved tremendously, the advantages of lower infection rate have made ASCs more attractive for surgery.
Q: What advice would you give to other surgeons wanting to perform narcotic-free surgeries in the outpatient setting?
EA: Perhaps the most important factor in performing narcotic-free surgery is having a well-trained anesthesia block service that is well-versed regional nerve block anesthesia. Working hand-in-hand with this team, optimal pain management protocols can be implemented.
Q: What non-narcotic pain management solution would you recommend to other surgeons?
EA: My preference is to use long-acting local anesthetic (Exparel). Half of this solution is incorporated in the regional nerve block, and depending on the extremity location, the other half is mixed with a regular local anesthetic. This is done to decrease the volume such that a more regional intraoperative field block can be effectively performed.
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