ENTtoday
  • Home
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

What Enhanced Recovery After Surgery Protocols Mean for Otolaryngology

by Nikki Kean • February 6, 2019

  • Tweet
  • Email
Print-Friendly Version

In an interview with ENTtoday, Adam Levine, MD, professor of anesthesiology, perioperative and pain medicine, otolaryngology, and pharmacological sciences at the Icahn School of Medicine at Mount Sinai in New York, NY, discussed some of the advances being made in otolaryngology anesthesia and ERAS protocols.

You Might Also Like

  • Survey Highlights Need for Opioid Prescription Guidelines in Otolaryngology Residency Programs, Continuing Medical Education
  • Chronic Opioid Use Common Even after Minor Surgery
  • Pediatric Consent Forms Decrease Overall Opioid Prescriptions
  • Vascular Stippling May Inform Diagnostic Sampling of Suspicious Laryngeal Lesions
Explore This Issue
February 2019

“I think the biggest innovation we’ve introduced is the use of regional anesthesia for head and neck patients. This has allowed us to perform anesthetic techniques that are opioid sparing, avoiding the intra- and postoperative use of long-acting opioids. When we use regional techniques, we have reduced levels of nausea and vomiting, lower opioid usage, and lower utilization of the post-acute care unit [PACU].”

According to Dr. Levine, who teaches workshops across the country, the head and neck region is innervated with a significant number of nerves. Although these innervations are complex, many of the nerves exit the skull, where landmarks are easy to identify without ultrasound, making them ideal candidates for regional blocks.

One example of a regional block technique is the sphenopalatine ganglion block. “We routinely perform a transoral approach to place the sphenopalatine nerve blocks,” noted Dr. Levine. “We perform the block post induction and endotracheal intubation—using an injection of 1.5 mL of 1% to 2% lidocaine with 1:100,000 of epinephrine. The epinephrine that is added to the local anesthetic helps both to decrease absorption in the area as well as improve the surgical field by reducing bleeding.” For most head and neck procedures, “we no longer utilize neuromuscular blockade,” he added.

For thyroid and parathyroid procedures, regional anesthesia techniques have allowed Dr. Levine to send patients home the day of surgery. “I really think that use of regional blocks and short-acting opioids intraoperatively expedites recovery—patients wake up, get moving, and get on with their lives without worrying about pain,” Dr. Levine said.

“I think the gestalt of ERAS for anesthesiology is to use the smallest anesthetic footprint we can possibly use—avoiding long-acting pharmacologic agents—and break the need or requirement for opioids.”—NK

Pages: 1 2 3 4 | Single Page

Filed Under: Features, Home Slider Tagged With: anesthesia, enhanced recovery after surgeryIssue: February 2019

You Might Also Like:

  • Survey Highlights Need for Opioid Prescription Guidelines in Otolaryngology Residency Programs, Continuing Medical Education
  • Chronic Opioid Use Common Even after Minor Surgery
  • Pediatric Consent Forms Decrease Overall Opioid Prescriptions
  • Vascular Stippling May Inform Diagnostic Sampling of Suspicious Laryngeal Lesions

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?
    • Keeping Watch for Skin Cancers on the Head and Neck
    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?
    • Vertigo in the Elderly: What Does It Mean?
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?
    • Vertigo in the Elderly: What Does It Mean?
    • What Happens to Medical Students Who Don’t Match?
    • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?
    • New Research Shows Sense of Smell Alters How We See Colors
    • Resident Unions Are Growing in Popularity in Otolaryngology
    • Is Caring for the Homeless and Uninsured Really Someone Else’s Problem?
    • Otolaryngology Practices Use Digital Tools to Pre-authorize—With Mixed Results
    • A Look at the Past, Present, and Future of DEI Medical Education Initiatives

Polls

Do you think resident unions are a positive development for otolaryngology?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2023 The Triological Society. All Rights Reserved.
ISSN 1559-4939