Becker's ASC Review

Executive Briefing: 70 EXECUTIVE BRIEFING 3 EXECUTIVE BRIEFING infusing automated boluses can help them avoid costly and time-consuming trips to the ER and reduces the strain on limited emergency resources so they can be used for sicker patients." Another useful feature of the Nimbus PainPRO postop pain pump is the patient-controlled analgesia function. Patients can hit a button on the pump and give themselves an additional dose of medicine, as needed. As Dr. Leslie Thomas observed, "Patients like having that Demand Bolus. I think we get a lot less calls because it's available. After the patient presses the bolus button and knows they will get relief, they get a lot more comfortable going home to recover after seeing that. That capability allows us to use lower doses than we ever thought would've worked." Nerve blocks and continuous catheters minimize or eliminate the use of opioids for postoperative pain Previously, the gold standard after surgery was to give patients substantial prescriptions for narcotic pain medicine, despite the risks and side effects. Now physicians are rethinking that approach in favor of more regional anesthesia. Intermittent bolus pumps like the Nimbus PainPRO have dramatically reduced patient use of opioids following outpatient orthopedic procedures. This is a positive step toward preventing drug diversion and improving the patient experience, since opioids affect appetite, sleep patterns and digestive processes. "We call our patients on postop day one and four," Dr. Leslie Thomas said. "Our shoulder patients rarely, if ever, take any opioids postop with these intermittent bolus pumps. Our surgeons absolutely love the new electronic pain pumps. It's incredible. Basically, all upper extremity cases are almost opioid free now. Some total knees and ACLs are still using some opioids, but it's a lot less." Dr. Scott Thomas echoed those results, "Prior to the adoption of regional anesthesia, the preferred method for treating severe pain following surgery was to administer high doses of opioid medications. A successful outpatient regional anesthesia program that utilizes these feature-rich pain pumps can oftentimes be the difference maker between competing facilities." Before deploying an electronic pain pump program, engage key stakeholders like Nursing, Pharmacy, and Supply Chain Post-anesthesia care unit nurses can be important advocates for electronic pain pumps. But if setting up the device for the patient requires extra steps, that can make them less attractive. "We have all of our specific infusion programs set up in our Nimbus pumps," Dr. Leslie Thomas said. "So, it's super easy for the nurses to set them up. I also think that's a safety aspect, which is why I prefer electronic pain pumps." Legacy elastomeric pain pumps must be filled with local anesthetic by the HOPD Pharmacy or by an outsourced pre- filling service for an ASC. For a busy postop acute pain service, that can require significant Pharmacy resources, or trigger greater expense by outsourcing every pump pre-fill. One advantage of newer electronic pain pumps like Nimbus® II PainPRO is that they infuse from a standard IV bag of medication — 500mL, 1000mL or a custom size for the procedure. Compared to labor-intensive elastomeric pump filling, preparing a bag in pharmacy can be a simpler task. And, if outsourced to a 503B compounder, a bag of local anesthetic typically costs less versus purchasing a prefilled pump. Electronic pumps like Nimbus are also recyclable, which can help facilities reduce supply chain waste and achieve sustainability. Each Nimbus pump comes with a box to return it for recycling purposes, but there is no penalty if patients don't return the pump. Other pump companies can require you to return equipment via FedEx or UPS. That obligation can be a challenge in large healthcare facilities. And, from a patient advocacy perspective, most ASCs don't want their patients to get a bill or be sent to collections for not returning a pump. Conclusion Electronic pain pumps and continuous catheters represent a positive evolution in pain management. "Often, patients are more anxious about their postoperative course, and anticipated pain specifically, than the actual surgery or anesthesia," Dr. Scott Thomas said. "Offering state-of-the- art regional anesthesia techniques with auto bolus pain pumps helps alleviate many patient concerns regarding pain management." Dr. Leslie Thomas summed up her thoughts: "When we went from elastomeric pumps to the electronic pumps with an intermittent bolus every three hours and the ability for patients to give themselves an on-demand dose every 30 minutes, that changed the ballgame." n The Nimbus® II PainPRO ambulatory, programmable, recyclable post-op pain pump is the only electronic pain pump offering: up to 12 protocol presets for easy setup and safe operation; Programmed Intermittent Bolus + Patient Demand Bolus + Continuous Rate infusion modes in any combination in any protocol; extending the duration of patient pain control out to 5 days with a 500mL anesthetic bag; infusing up to 1000mL from any vendor's IV medication bag; Delay Start smart timer to delay your catheter infusion until the patient's surgical block is wearing off; informative display screen to help your patients' basic question "Is my pump working?". All of this at cost less than your current pump supplier. Learn more: www.nimbuspainpro.com or call 1-844-479-8500. InfuTronix Solutions is part of the Natick, MA based InfuTronix family of advanced healthcare infusion entities including Zyno Solutions for ambulatory oncology infusions and CareEverywhere for infusion device data integration management.

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