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OBJECTIVE Given the growing number of ambulatory surgeries being performed and the variability in postoperative pain requirements, early discharge, and inconsistent follow-up, ambulatory surgery presents a unique challenge for this patient population and warrants the presence of an ambulatory pain specialist to evaluate a patient preoperatively and postoperatively to optimize patient safety and satisfaction. This article explores the crucial role that a dedicated pain physician would have in the ambulatory surgery setting. RESULTS The prevalence of chronic pain, opioid use, and substance abuse is growing in this country, while ambulatory and same-day surgery have also experienced considerable growth. Inevitably, more patients with challenging chronic pain or substance abuse are having ambulatory surgery. Increased BMI, advanced age, more comorbidities warranting a higher ASA physical status classification, and longer surgeries are now all components of ambulatory surgery that contribute to increased risk too. Certain surgeries including breast surgery, inguinal hernia repair, and thoracotomy are at higher risk for the conversion of acute to chronic pain, and an ambulatory pain specialist would be beneficial for added focus on these patients. Multimodal pain control with non-opioids and regional anesthesia adjuvants are beneficial, while emphasis on a patient's functional capacity may be more useful than quantifying the severity of pain. Despite the best efforts of patients' primary care providers or surgeons, patients often are discharged with more chronic opioid therapy than they presented with, and an ambulatory pain specialist can help manage the complications and prevent further escalation of this opioid epidemic. An onsite anesthesiologist with interest in pain management in each ambulatory surgery center administering anesthesia and available onsite to deal with immediate preoperative, intraoperative, and recovery room would be ideal to curb and manage complication from uncontrolled pain and related pain issues.
Donna-Ann Thomas, and
Daniel Chang, and
Richard Zhu, and
Hassan Rayaz, and
Nalini Vadivelu
January 2001,
Bulletin de l'Academie nationale de medecine,
Donna-Ann Thomas, and
Daniel Chang, and
Richard Zhu, and
Hassan Rayaz, and
Nalini Vadivelu
October 1953,
Medizinische Monatsschrift,
Donna-Ann Thomas, and
Daniel Chang, and
Richard Zhu, and
Hassan Rayaz, and
Nalini Vadivelu
July 1987,
Ambulatory care,
Donna-Ann Thomas, and
Daniel Chang, and
Richard Zhu, and
Hassan Rayaz, and
Nalini Vadivelu
April 1969,
Minerva medica,
Donna-Ann Thomas, and
Daniel Chang, and
Richard Zhu, and
Hassan Rayaz, and
Nalini Vadivelu
January 1968,
Revue de medecine psychosomatique et de psychologie medicale,
Donna-Ann Thomas, and
Daniel Chang, and
Richard Zhu, and
Hassan Rayaz, and
Nalini Vadivelu
May 1986,
Ceskoslovenske zdravotnictvi,
Donna-Ann Thomas, and
Daniel Chang, and
Richard Zhu, and
Hassan Rayaz, and
Nalini Vadivelu
January 1986,
Daedalus,
Donna-Ann Thomas, and
Daniel Chang, and
Richard Zhu, and
Hassan Rayaz, and
Nalini Vadivelu
January 1986,
Daedalus,
Donna-Ann Thomas, and
Daniel Chang, and
Richard Zhu, and
Hassan Rayaz, and
Nalini Vadivelu
January 1976,
The P. A. journal,
Donna-Ann Thomas, and
Daniel Chang, and
Richard Zhu, and
Hassan Rayaz, and
Nalini Vadivelu
January 1953,
Acta neurovegetativa,
