Dr. Vincent Kasper recently co-authored a study exploring pain management after complex foot and ankle surgery in outpatient settings. Specifically, the study compared postoperative pain control in patients receiving a continuous popliteal infusion with single-injection saphenous nerve block–versus a continuous popliteal infusion with continuous saphenous infusion. All of the continuous infusions were delivered through Halyard Health’s ON-Q* Pain Relief System.

Kasper, who currently serves as Chief of Anesthesia at the Jefferson Surgical Center at The Navy Yard, Chief Anesthesiologist at Rothman Specialty Hospital, and anesthesiologist at United Anesthesia Services in Philadelphia, PA, demonstrated that patients who were in the dual pump group experienced lower pain levels and used less narcotics days 1 and 2 post-operatively, than the group that used the pump with the single injection nerve block. DOTmed News reached out to him to get a better understanding of this those findings mean.

DOTmed News: Why were you compelled to conduct this study?

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Dr. Vincent Kasper: Previously, complex foot and ankle procedures took place primarily in hospitals and inpatient settings due to the challenges involved in post-operative pain management. But today, these types of surgeries are increasingly being performed in outpatient facilities, instead.

This is possible in part because of non-narcotic pain management therapies and other advances in the field. In the past, patients undergoing complex surgeries of this nature had to use narcotics to manage the pain, which often prolonged their recovery time, increased their length of hospital stay, and negatively impacted their satisfaction.

In my practice, I’ve made a concerted effort to minimize the use of opioids whenever possible by using alternative pain management techniques, including nerve blocks, such as Halyard’s ON-Q pain pump. This has enabled me to conduct these types of procedures seamlessly in outpatient settings. I wanted to confirm whether or not the benefits I’ve observed first-hand by taking this approach would hold true for a larger patient population — it turned out that it did.

DOTmed News: What were some of the challenges you experience when administering narcotic post-operative pain solutions?

VK: In addition to increasing the likelihood of addiction and the probability of adverse reactions, using narcotics to manage pain after surgery increases the chances that a patient will be readmitted to the hospital for pain control. This pattern holds true even if patients have been prescribed the highest allowable dosage of narcotics.

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