Pain Management: Intel For Your OR

Amneal’s new Ropivacaine infusion bag manages acute pain for a patient’s pain management program for successful surgical procedures in the ambulatory setting.

As the ambulatory environment continues to evolve, outpatient facilities are utilizing regional pain blocks to control pain management in select patients who are undergoing complex surgeries in the outpatient setting. In fact, regional anesthesia offers effective pain management for total joints and hip and knee surgery, among other procedures, with opioid-sparing results that benefit the patient’s recovery.

Today, the outpatient community is looking at the components of a multimodal pain management approach as OR teams are learning about the benefits, no matter what the procedure. While the local or regional anesthesia approach is not yet standard, more OR leaders are investigating the techniques and products that aid in creating pain management protocols for their facility.

As pain management continues to evolve, new products play an important role. Amneal has introduced Ropivacaine Hydrochloride Injection, USP, and has launched this product in two sizes: 200mg/100mL (2mg/mL), and 400mg/200 mL (2mg/mL), with a 500mg/100mL (5mg/mL) coming soon.

Ropivacaine hydrochloride Injection is indicated for the production of local or regional anesthesia for surgery and for acute pain management. For Surgical Anesthesia, this product is indicated for these procedures: epidural block for surgery including cesarean section; major nerve block; local infiltration. For Acute Pain Management this product is indicated for: Epidural continuous infusion or intermittent bolus, e.g., postoperative or labor; local infiltration. Ready-to use bags, like Ropivacaine, mark an expansion of the Amneal portfolio of products. Please see full prescribing information.

Amneal Pharmaceuticals, Inc. is a fully integrated global essential medicines company powered by a robust U.S. generics business and a growing branded business as well as deepening portfolios in institutional injectables, biosimilars and select international markets. Together, we’re rapidly becoming one of the most dynamic, purpose-driven pharmaceutical companies delivering more affordable access to essential medicines.

Today, Amneal is much more than generics. A series of strategic investments over the years has bolstered our world-class scientific rigor, production capabilities and commercial infrastructure. We have also invested substantially in our people through leadership development and employee well-being programs. Together, these advancements have accelerated our ability to deliver innovation, more complex products and broadened portfolios in new categories and geographies. Two decades after our founding, Amneal is better positioned than ever to deliver outcomes that meet important medical needs, make quality medicines more accessible and more affordable, and provide solutions for tomorrow’s health challenges. We are Amneal and We make healthy possible. For more information, please visit www.amneal.com.

Here’s a look at the latest devices on the market as well as the features that set them apart from the competition.

Need help convincing upper management to invest in smoke evacuation systems for your busy surgical facility? There are plenty of compelling reasons why smoke-free ORs should be viewed as the standard of care for every plume-producing procedure, as opposed to a nice-but-unaffordable option.

For starters, you may not get a say in the matter soon. Thanks to the grassroots lobbying efforts of organizations like AORN and the brave actions of surgical-smoke victims like Angela Hohn (Article | Outpatient Surgery Magazine (aorn.org), 16 states now require smoke-free ORs – and more have laws pending. Even the most hesitant C-suite should be able to see it’s only a matter time before smoke evacuation systems will be required.

If that’s not enough, studies confirm what healthcare professionals have long suspected: Surgical smoke is toxic and potentially deadly to OR staff. The literature conclusively proves that surgical smoke transmits toxins, carcinogens, viruses and other hazardous particles directly through masks and right into the respiratory systems of OR staff.

Convincing upper management investing in smoke evacuation is a critical endeavor is only part of the process. You still need to find the right system for your needs. To do this effectively, ask potential vendors the tough questions about:

• True cost. The initial cost of the equipment is obviously a key consideration, but it’s not the only factor when comparing prices. Facility leaders should budget for the additional cost of disposables such as filters, tubing and other supplies of the device. Certain vendors will offer deals, where the evacuator/evacuators are free in exchange for signing a contract in which you agree to exclusively purchase their supplies.

• Noise. Older models were notoriously L-O-U-D, but manufacturers have worked diligently to solve this common complaint. Still, this is an area where it’s worth trialing several devices to find the best option. After all, noise in the OR hinders the effective communication necessary to ensure positive outcomes. Look for evacuators that automatically turn suction on and off during electrosurgery and laser procedures, use so the devices aren’t running constantly.

• Efficiency. The standard filters in smoke evacuators - Ultra-Low-Penetration Air or ULPA filters – are designed to capture 99.999% of airborne particles, meaning only one in one million particles escape but filtration isn’t the only efficiency metric to evaluate. While trialing the evacuator, make sure the suction pulls effectively and check to see if it activates instantly or, while the device is ramping up, it misses some of the plume.

Here are some of the latest devices on the market:

Breathe Easy in the OR While You Improve Efficiency

Applied Medical Technology

Keep your OR free of toxic surgical smoke with the Remora Smoke & Fluid Evacuation System from Applied Medical Technologies. The Remora attaches to/works with almost any electrosurgical pencil, and has a universal suction adapter that plugs into most OR suction sources. Remora comes in both standard and micro configurations to accommodate a variety of surgical procedures.
• Removal of carcinogens and toxins from the OR
• Simultaneous removal of smoke and fluids
• Instant removal at point of origin
• Compliant material protects delicate tissues
• Alternate ports prevent blockage and reduces trauma to tissue

For more information, call (800) 869-7382, visit www.AppliedMedical.net or here.

Let’s Clear the Air!

Medtronic

Over 150 hazardous chemicals have been identified in surgical smoke, including 12 times the recommended exposure limit of furfural. Help yourself, your team, and your patients avoid surgical smoke respiratory health risks with the Valleylab Smoke Evacuation Laparoscopic Smoke Evacuation System from Medtronic. The Valleylab Smoke Evacuation Laparoscopic Smoke Evacuation system removes and filters surgical smoke for better visualization and improved air quality during laparoscopic procedures, and Valleylab Smoke Evacuation Pencils provide efficient smoke removal during open surgical procedures.

For more information, visit medtronic.com/smokeevac or here.

The Integration Solution that Tailors Your OR Experience

Northgate Technologies, Inc.

The Nebulae 1 50 LPM Insufflation System from Northgate Technologies, Inc. (NTI) provides higher clinical performance when you need it most. This cost-effective insufflation system allows surgeons to enhance their procedure at any time—so you don’t need to commit to an expensive setup at the beginning of the operation.
• Maintain a stable pneumo with high-flow smoke evacuation
• Adjustable pressure settings accommodate pediatric to bariatric laparoscopic and robotic procedures
• Luer-lock connection allows for any standard trocar connection
• Evacuate smoke and reduce CO2 gas usage

For more information, call (800) 348-0424, visit www.ntisurgical.com or here.

Leave the Status Quo Behind

Northgate Technologies, Inc.

Minimize smoke exposure in the OR while maintaining pneumoperitoneum stability, visibility, performance, and safety with Nebulae SRS laparoscopic surgical smoke removal system from Northgate Technologies, Inc. Nebulae SRS uses an innovative closed-loop system that forms a seamless extension of the pneumoperitoneum to actively filter and capture contaminants while warming recirculated CO2 gas; avoids excess usage of CO2 gas and exchange of CO2 gas cylinders due to smoke evacuation.

For more information, visit ntisurgical.com/nebulae-srs or here.

Looking for Seamless Smoke Removal?

Operating Room Innovations

SmokeStop from Operating Room Innovations (ORI) is the single-use smoke evacuator accessory you need to remove surgical smoke at the source. Designed by surgeons, for surgeons, SmokeStop’s sterile, noninvasive mini-vac tips connect to standard smoke tubing of any approved powered suction filtration device. SmokeStop is a hands-free smoke evacuator accessory that increases surgical site visualization, enhances workflow efficiency, and does not require a bulky cautery pencil or added electric suction devices.

For more information, call (619) 210-0726, visit orinnovations.com or here.

The Easy Way to Stop Smoking in the OR

Stryker Surgical Technologies

Free your ORs from harmful surgical plume with Stryker's expanded Neptune SafeAir smoke evacuation portfolio. The new easy-to-use SafeAir Compact Smoke Evacuator quietly sucks the plume through a ULPA filter that cleans the air of hazardous particles. Pair it with the new SafeAir Telescopic Smoke Evacuation Pencil; the electrode and suction tube can telescope out to 4.75 inches. When you don't need the telescoping function, use the SafeAir Smoke Evacuation Pencil. Product trials available.

For more information, visit safeor.com or here. OSM