Eugene R. Viscusi, MD

Eugene Viscusi, MD
 

Associate Professor
Director, Acute Pain Management Service
Department of Anesthesiology
Thomas Jefferson University
Philadelphia, Pennsylvania

What are ASA/APS guideline recommendations for multimodal perioperative pain management and how important are opioids as drivers to prolongation of LOS? Video

What are ASA/APS guideline recommendations for multimodal perioperative pain management and how important are opioids as drivers to prolongation of LOS?

What are the ASA/APS guideline recommendations for multimodal perioperative pain management and how important are opioids as drivers to prolongation of LOS associated with surgical procedures?
Eugene Viscusi, MD

Eugene Viscusi, MD

What is the evidence that opioid-related side effects compromise patient-related outcomes and satisfaction? And prolong LOS? Video

What is the evidence that opioid-related side effects compromise patient-related outcomes and satisfaction? And prolong LOS?

What is the evidence that opioid-related side effects compromise patient-related outcomes and satisfaction? And prolong LOS?
Eugene Viscusi, MD

Eugene Viscusi, MD

What is the optimal dosing schedule for IV acetaminophen and how should it be combined with opioid therapy? Video

What is the optimal dosing schedule for IV acetaminophen and how should it be combined with opioid therapy?

What is the optimal dosing schedule for IV acetaminophen and how should it be combined with opioid therapy?
Eugene Viscusi, MD

Eugene Viscusi, MD

Are there situations where you might consider the use of IV acetaminophen as monotherapy for certain surgical procedures, as opposed to its use as part of a multimodal approach? Video

Are there situations where you might consider the use of IV acetaminophen as monotherapy for certain surgical procedures, as opposed to its use as part of a multimodal approach?

Are there any situations where you might consider the use of IV acetaminophen as part of monotherapy for certain surgical procedures, as opposed to its use as a non-opioid foundational agent that is part of a multimodal approach requiring rescue with opioids?
Eugene Viscusi, MD

Eugene Viscusi, MD

What are the mechanism(s) of action by which IV acetaminophen exerts its pain-relieving properties and how is this differentiated from other agents? Video

What are the mechanism(s) of action by which IV acetaminophen exerts its pain-relieving properties and how is this differentiated from other agents?

What are the mechanism(s) of action by which IV acetaminophen exerts its pain-relieving properties and how is this differentiated from other agents?
Eugene Viscusi, MD

Eugene Viscusi, MD

How does the MOA of IV acetaminophen suggest how to combine it with other agents as part of multimodal management for ERAS? Video

How does the MOA of IV acetaminophen suggest how to combine it with other agents as part of multimodal management for ERAS?

How does the MOA of IV acetaminophen suggest how to combine it with other agents as part of multimodal management for ERAS?
Eugene Viscusi, MD

Eugene Viscusi, MD

Is there a patient preference component that is a significant driver to helping select agents for multimodal therapy? And what about expectations as part of the ERAS pathway? Video

Is there a patient preference component that is a significant driver to helping select agents for multimodal therapy? And what about expectations as part of the ERAS pathway?

Is there a patient preference component that is a significant driver to helping select agents for multimodal therapy? And what about expectations as part of the ERAS pathway?
Eugene Viscusi, MD

Eugene Viscusi, MD

Do studies provide information about the comparative efficacy of non-opioid agents used as part of multimodal perioperative pain management? What about comparative safety? Video

Do studies provide information about the comparative efficacy of non-opioid agents used as part of multimodal perioperative pain management? What about comparative safety?

Do we have studies that provide information about the comparative efficacy of non-opioid agents used as part of multimodal perioperative pain management? And what about comparative safety?
Eugene Viscusi, MD

Eugene Viscusi, MD

From a safety and efficacy standpoint, what is the rationale for using such agents as IV acetaminophen as part of multimodal analgesia to reduce overall opioid consumption? Video

From a safety and efficacy standpoint, what is the rationale for using such agents as IV acetaminophen as part of multimodal analgesia to reduce overall opioid consumption?

From a safety and efficacy standpoint, what is the rationale for using such agents as IV acetaminophen as part of multimodal analgesia to reduce overall opioid consumption?
Eugene Viscusi, MD

Eugene Viscusi, MD

Can you walk us through the practical and “best practice” aspects and roadmap for how to dose and infuse IV acetaminophen, including timing and duration of administration as part of an ERAS protocol? Video

Can you walk us through the practical and “best practice” aspects and roadmap for how to dose and infuse IV acetaminophen, including timing and duration of administration as part of an ERAS protocol?

Can you walk us through the practical and “best practice” aspects and roadmap for how to dose and infuse IV acetaminophen, including timing and duration of administration as part of an ERAS protocol?
Eugene Viscusi, MD

Eugene Viscusi, MD

What is the importance of avoiding the hepatic first-pass effect when using IV versus oral acetaminophen, and what PK advantages and tissue penetration effects are observed? Video

What is the importance of avoiding the hepatic first-pass effect when using IV versus oral acetaminophen, and what PK advantages and tissue penetration effects are observed?

What is the clinical importance of avoiding the hepatic first-pass effect when using the IV versus oral formulation of acetaminophen, and what PK advantages and tissue penetration/compartment effects are observed that are responsible for improved efficacy?
Eugene Viscusi, MD

Eugene Viscusi, MD

Can you summarize the literature- and trial-based support for the use of IV acetaminophen as part of multimodal pain management in the surgical setting? Video

Can you summarize the literature- and trial-based support for the use of IV acetaminophen as part of multimodal pain management in the surgical setting?

Can you summarize the literature- and trial-based support for the use of IV acetaminophen as part of multimodal pain management in the surgical setting?
Eugene Viscusi, MD

Eugene Viscusi, MD

Is the efficacy of IV acetaminophen “universal” across many types of surgical procedures? Video

Is the efficacy of IV acetaminophen “universal” across many types of surgical procedures?

Is the efficacy of IV acetaminophen “universal” across many types of surgical procedures?
Eugene Viscusi, MD

Eugene Viscusi, MD

What trial-based evidence do you think is most compelling to support the use of IV acetaminophen in TKR and THR -- a high pain model in orthopedic surgery context? Video

What trial-based evidence do you think is most compelling to support the use of IV acetaminophen in TKR and THR -- a high pain model in orthopedic surgery context?

What trial-based evidence do you think is most compelling to support the use of IV acetaminophen in the setting of TKR and THR — a high pain model in orthopedic surgery context? Can you summarize the data? What did we learn about the degree ...
Eugene Viscusi, MD

Eugene Viscusi, MD

Is there a risk of acetaminophen masking a surgical infection because of its anti-pyretic effect? Video

Is there a risk of acetaminophen masking a surgical infection because of its anti-pyretic effect?

Is there a risk of acetaminophen masking a surgical infection because of its anti-pyretic effect?
Eugene Viscusi, MD

Eugene Viscusi, MD

What makes the side effect profile of IV acetaminophen uniquely suited for perioperative pain management as compared to IV opioids? Video

What makes the side effect profile of IV acetaminophen uniquely suited for perioperative pain management as compared to IV opioids?

What makes the side effect profile of IV acetaminophen uniquely suited for perioperative pain management as compared to IV opioids?
Eugene Viscusi, MD

Eugene Viscusi, MD

What are the contraindications to the use of IV acetaminophen? Video

What are the contraindications to the use of IV acetaminophen?

What are the contraindications to the use of IV acetaminophen?
Eugene Viscusi, MD

Eugene Viscusi, MD

What other agents or perioperative physiological factors can affect absorption of oral acetaminophen, thereby making this route potentially problematic and less reliable than IV acetaminophen? Video

What other agents or perioperative physiological factors can affect absorption of oral acetaminophen, thereby making this route potentially problematic and less reliable than IV acetaminophen?

What other agents or perioperative physiological factors can affect absorption of oral acetaminophen, thereby making this route potentially problematic and less reliable than IV acetaminophen?
Eugene Viscusi, MD

Eugene Viscusi, MD

What is your strategy in a patient who has become intolerant of an opioid? Video

What is your strategy in a patient who has become intolerant of an opioid?

What is your strategy in a patient who has become intolerant of an opioid?
Eugene Viscusi, MD

Eugene Viscusi, MD

How rapid is the onset of action for IV acetaminophen and when is the C-Max achieved after a 15-minute infusion? How does the IV formulation C-Max metrics compare to the oral formulation? Video

How rapid is the onset of action for IV acetaminophen and when is the C-Max achieved after a 15-minute infusion? How does the IV formulation C-Max metrics compare to the oral formulation?

How rapid is the onset of action for IV acetaminophen and when is the C-Max achieved after a 15-minute infusion? How does the IV formulation C-Max metrics compare to the oral formulation?
Eugene Viscusi, MD

Eugene Viscusi, MD

What do we know about patient satisfaction as it relates to perioperative pain management, including in patients on IV acetaminophen? And what role does opioid reduction play? Video

What do we know about patient satisfaction as it relates to perioperative pain management, including in patients on IV acetaminophen? And what role does opioid reduction play?

What do we know about patient satisfaction as it relates to perioperative pain management, including in patients on IV acetaminophen? And what role does opioid reduction play?
Eugene Viscusi, MD

Eugene Viscusi, MD

What is the importance of opioid avoidance as a strategy for multimodal pain management in the perioperative setting? Where does IV acetaminophen fit into that best pain management equation? Video

What is the importance of opioid avoidance as a strategy for multimodal pain management in the perioperative setting? Where does IV acetaminophen fit into that best pain management equation?

What is the importance of opioid avoidance as a foundational strategy for multimodal pain management in the perioperative setting? And where does IV acetaminophen fit into that best pain management practice equation?
Eugene Viscusi, MD

Eugene Viscusi, MD