Same-day orthopedic surgery allows patients to recover in the comfort of their own homes rather than in a hospital bed, and provides multiple benefits to patients for improved recovery. And the drive to perform total joint replacement procedures on an outpatient basis continues to increase.

Russell Presley Swann, MD, of Indianapolis-based Methodist Sports Medicine, shared his thoughts on postoperative pain management after outpatient orthopedic procedures with MD Magazine.

A potential challenge clinicians and claim administrators  must take into account when considering outpatient total joint procedures with their patients is effective management of post-operative pain. More than 73 million surgical procedures are performed in the US each year, and up to 75% of patients may experience pain after surgery. Inadequate pain management remains common and can result in a number of negative clinical outcomes, including deep vein thrombosis, pulmonary embolism, coronary ischemia, myocardial infarction, pneumonia, poor wound healing, insomnia, and demoralization.3

Until recently, post-operative pain was primarily treated with opioids – and according to the CDC, the increase in opioid prescribing is a contributing factor to the increase of prescription overdoses. Opioid-based pain medications may produce significant adverse effects, with both clinical and financial consequences. Even a 1-day opioid prescription may pose a 6% risk of long-term opioid use, and as many as 1 in 5 patients become a routine opioid user after 10 days of narcotic analgesia.

New techniques and approaches like continuous peripheral nerve blocks (CPNBs) are playing a significant role in making post-operative pain more manageable and providing patients with superior acute postoperative pain relief while decreasing the amount of opioid-related adverse effects. CPNBs have been successfully introduced in the ambulatory setting to provide on-going analgesia at home, as well as in the hospital setting. CPNBs can also help patients ambulate faster and improve their range of motion more quickly.

Through careful planning and leveraging effective pain management techniques such as CPNBs, same-day joint procedures are a realistic option for many patients. However, as with everything in healthcare, open communication with both patients and their caregivers is critical.

This is not only the case for decisions around the procedure itself but the recovery process as well. Many patients may still be unaware that there are alternatives to opioids for post-surgical pain relief and may be hesitant to undergo a procedure as a result.

By ensuring patients and their caregivers are educated regarding their options for both care delivery and pain management, we are providing a needed opportunity to improve the overall patient experience while increasing satisfaction and speeding post-surgical recovery.