HELPFUL FINDINGS

• According to a Brunswick Hills OB/GYN, Dr. Elizabeth Cherot, "in addition to receiving more opioids, women are 40 percent more likely than men to become newly persistent opioid users following surgery."
• Women who give birth vaginally or without any complications are not given any opioid pain medication.
• Even though more than half of women go through a C-section, they are all provided with a non-opioid pain management option.
• According to a recent survey, nearly 9 out of 10 mothers or expecting mothers are concerned about opioid pain management. However, only 11% discussed a non-opioid option with their OB/GYN.
• According to the American College of Obstetricians and Gynecologists (ACOG), "pain management for postpartum patients should be individualized in a stepwise approach, and a multimodal approach including acetaminophen NSAIDs to opioids."
• Also, patient safety objectives by ACOG demand that there should be an environment at healthcare institutions where "all caregivers feel safe in reporting errors, near misses, and at-risk behaviors by themselves and others."
•  Sleep deprivation of patient caregivers is recognized as a major obstacle in patient safety for OB/GYN patients.

RESEARCH STRATEGY:

Role of Caregivers in the Pain Management of the Patients

•  Caregivers play an important role relating to the complete timeline an anesthesiology patient goes through, from the preoperative stage to the postoperative stages due to the positive influence their participation has on improvements in the allocation of health care resources, patient and family satisfaction, chronic disease self-management, morbidity, and mortality."
• According to the Association of American Medical Colleges MedEd portal report, caregivers influence physicians' decisions on how to proceed with the anesthetic procedure.
•  Caregivers have the important role of calming the patient, explaining what the procedures are and ensuring the smooth running of the operation. They are vital due to the patient\physician relationship being new, which makes it difficult for patients to feel comfortable or trust physicians during the preoperative stage.

Influence on Physicians Decisions around Pain Management

• According to a study from a pediatric surgical program on the patient and family-centered care defends the positive impact of caregivers involved in the patients' pain management mainly due to the reduction of anxiety — therefore reducing the quantity of sedative medicine administered — this study included the comparison of preoperative Midazolam administration, preoperative time and induction time.
• According to the Canadian Institute of Health and Research's information bank, Midazolam is a short-acting hypnotic-sedative drug with an anxiolytic, muscle relaxant, anticonvulsant, sedative, hypnotic, and amnesic properties.
• The quantity of the preoperative use of Midazolam uses reduced from 41% (392/964) to 13% (16/118) — the program received a rating of 99.2% efficiency by caregivers and 77.5% efficiency by the medical staff.
• The caregivers defended that their presence during the preoperative process greatly reduced anxiety for them by 87.1% and their child by 93.2%. 
• It is a physician obligation to honor respect and oblige to the patients' families/caregivers choices, automatically, this would ultimately influence the physicians' decisions revolving the correct manner in which to proceed with the care and medicine administration of the patient.
•  Caregivers may influence physicians to try new products if previous records show that the standardized products administered have a bad reaction or are ineffective on the patient.
• Furthermore, physicians are the party with medical expertise, giving them the ultimate power to decide whether a new product is suitable for the patient at hand.

RESEARCH STRATEGY

PATIENT PERCEPTIONS OF OB/GYN PROCEDURES

Planned C-sections

• Around 10% of women in the U.S. are highly worried about labor pains and opt for C-sections. Women who opt for C-sections experience some physical and psychological difficulties and few patients stress over painful recoveries after the C-section.

Mastectomy

• As per a case study by the University of South Florida, patients who underwent mastectomy experienced a pain level of 0.4 to 2.5 out of 10, which lasted for one day.

INFLUENCES AND PREVENTION TECHNIQUES OF OB/GYN SURGEONS

Planned C-sections

• For patients who opt for C-sections, OB/GYN surgeons suggest various types of sedation for pain management such as regional anesthesia and general anesthesia. The types of regional anesthesia used are spinal anesthesia and epidural anesthesia.
• Most often OB/GYN surgeons suggest regional anesthesia which makes the mother aware of the baby’s first cry. Surgeons use general anesthesia when the mother strongly prefers it due to her perception of pain or in case of surgical emergencies.
• Though general anesthesia is safe, it is not the preferred choice of surgeons and it is only used when it is a patient’s strong preference.
• Medication is altered even after the surgery based on the patient’s pain perception.
•  Ibuprofen and acetaminophen are the drugs given after a C-section based on a patient’s pain perception. Opioids are prescribed based on the patient’s need.

Mastectomy

• To avoid or reduce the fear of pain before a mastectomy, OB/GYN surgeons suggest using Tylenol before the surgery and avoid using vitamin E supplements and aspirin.
• Surgeons also suggest listening to music and focusing on reading.
•  General anesthesia is the first choice for mastectomy sedation, however, patients can choose the type of sedation after discussing this with the surgeon.
• Surgeons alter a wide variety of medication to induce anesthesia based on the patient’s preference for the surgery.
• OB/GYN surgeons give the best possible dosage regimen to patients with chronic postoperative pain after a mastectomy by collaborating with anesthesiologists.
• OB/GYN surgeons prescribe narcotics if there is intense pain whereas, for moderate pain medications such as Vicodin, Ibuprofen or Tylenol are prescribed.

RESEARCH STRATEGY

USEFUL FINDINGS:

• According to a study on the patient perceptions and expectations about postoperative analgesia, 100% of patients believed they would receive analgesics after surgery. Out of which about 37% of patients believed they would receive Tylenol, 18% Motrin, and 77% opioids.
• The study also reported that patients not expecting to receive opioids postoperatively, still believed opioids would be superior to non-opioid medications.
• The study results showed that patients expected to experience pain after surgery were given analgesics.
• The patient perceptions of pain management therapy study reported that measuring patient satisfaction of pain has become critical in evaluating the treatment. The factors that affect patient satisfaction with pain management include the adequacy of teaching they receive and the therapy they receive.
• The study reported that nurses must understand their patients' perception to help meet analgesic goals.
• Candice Morrissey, Assistant Professor at University of Utah School of Medicine, believes that anesthesiologists want specific patient feedback to improve upon medical care.
• Candice Morrissey also says that getting patients feedback about treatment helps to know if patients understood us, felt their care was coordinated, and got the feeling their wishes would be observed.
• A Chorionic Villus Sampling procedure was conducted to determine the pain perception among patients during antenatal genetic testing.

RESEARCH STRATEGIES

• There are no research reports, articles, and journals on how patient perceptions of pain influence the pain management / prevention techniques of anesthesiologists in the public domain.
• This could be due to the niche nature of the request and also no organization has done research on this type of topic due to the costs involved and less demand for such type of reports.

HELPFUL FINDINGS

• Opioid prescribing and use is of particular relevance to obstetrics and gynecology practice. Cesarean delivery (C-section) is the most common inpatient surgical procedure performed in the United States—approximately 1.3 million women undergo this procedure each year, and virtually all are prescribed opioid medications as a result.
• The American College of Obstetricians and Gynecologists (ACOG) recommends pharmacologic and nonpharmacologic therapies for managing postpartum pain management as pain can interfere with a woman’s ability to care for herself and her infant.
• According to a study, the amount of opioid prescribed after cesarean delivery generally exceeds the amount consumed by a significant margin, leading to substantial amounts of leftover opioid medication. Lower opioid prescription correlates with lower consumption without a concomitant increase in pain scores or satisfaction.
• According to a study, female OB/GYNs are less likely than males to receive top patient satisfaction scores.
• According to an NCBI study, a study sample comprised of 1,903 obstetricians and gynecologists and 6,035 other specialists, on a scale of 0–100, the mean satisfaction with physician score was 65.1 for obstetricians and gynecologists and 58.1 for other specialists. Patient satisfaction due to the physician’s caring and friendly attitude was 6.65 (P < 0.001) for obstetricians and gynecologists and 5.86 (P < 0.001) for other specialists.
• Overall, patients waited a significantly shorter time for obstetrician and gynecologist visits, averaging at 26.8 minutes, compared to other specialists.

RESEARCH STRATEGY

HELPFUL INSIGHTS

• Anesthesiologists' skills in regional anesthesia contribute to advances in pain management, securing them an important role in chronic pain management. Many chronic pain patients are inappropriate candidates for such treatments. Much of the confusion surrounding their treatment with nerve blocks results from anesthesiologists extrapolating from their management methods for acute and cancer pain, where pain relief is the goal, to chronic non-malignant pain where long-term pain relief is usually an unrealistic goal.
• According to the Anesthesia Quality Institute, there is currently no standard for anesthesiology patient survey questions which makes the comparison of satisfaction results across facilities or practices very difficult.
• Hospitals do not have mechanisms for getting feedback on patients’ anesthetic experience because anesthesiology is connected with feeling nothing, that is, a lack of experience.
•  Postoperative pain is one of the anesthesiology symptoms that can be addressed by multimodal drug regimens.
• The Iowa Satisfaction with Anesthesia Scale (ISAS) is a self-administered written questionnaire used by some hospitals that focuses on monitored anesthesia care rather than the perioperative process.
• According to anesthesiologist Candice Morrissey from the University of Utah, anesthesiologists are not using patient feedback enough to improve the care they provide.

RESEARCH STRATEGY:

1. OB/GYN SURGEONS: PAIN MANAGEMENT CONFIDENCE LEVEL

• Obstetrician-gynecologists, or OB/GYNs, have specialized knowledge of the female reproductive system, including sexually transmitted infections (STIs) and chronic pain.
• OB/GYNs often handle labor pain in remote environments, have no other specialists around them, and exhibit more confidence in their abilities to succeed.
• All OB/GYN surgeons have gone through "extensive education" and have "practical experience." A minimum of four years of college studies in pre-medicine or science prepares them for the OB/GYN profession. They follow up this training with four years of medical school training.
• Obstetrician-gynecologists have detailed information regarding pain management (both pre and postoperative pain). The American College of Obstetricians and Gynecologists (ACOG) publication guides its members on how to manage postoperative cesarean pain. The American College of Obstetricians and Gynecologists encourages the use of standard oral and parenteral analgesic adjuvants such as acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), as well as opioids.
• Obstetrician-gynecologists are also guided on how to use preoperative doses of dexamethasone to improve analgesia, decrease nausea and vomiting in patients on the first postoperative day by the website of the American College of Obstetricians and Gynecologists.
• According to recent web traffic analysis, (screen capture available here), the website of the American College of Obstetricians and Gynecologists has about 1.24 million views every six months. About 57.25% of this traffic originates from the United States, indicating that American OB/GYNs are taking advantage of ACOG web publications. It was therefore assumed that this boost in knowledge also boosts confidence levels.

2. OB/GYN SURGEONS: VIEW ON PAIN MANAGEMENT

• Publications in obstetrics and gynecology reveal that OB/GYN surgeons who manage pain in women believe that pain and fatigue adversely interfere with women and their ability to care for themselves and their infants. OB/GYNs also agree that untreated pain comes with the "risk of greater opioid use," causes postpartum depression, etc.
• Publications in obstetrics and gynecology also reveal that OB/GYN surgeons believe pain management should involve both the patient and physicians. They opine that a "shared decision-making approach" to postpartum pain management and discharge opioid prescription will optimize pain control and also reduce cases of unused opioid tablets.
• The "shared decision-making approach" (SDM) in pain management is considered by a majority of medical experts as an integral path to achieving patient-centered care in the practice of clinical medicine. This process helps clinicians inform patients on treatment options and captures patient preferences in the decision-making process to promote favorable "health outcomes."

3. OB/GYN SURGEONS: CONTINUING EDUCATION ON NEW TECHNIQUES

• All OB/GYN physicians have gone through medical school and must spend four years learning specific skills relevant to obstetrics and gynecology in a residency program. After passing a licensing exam, some students typically continue their studies and get specialized knowledge via a Fellowship training.
• OB/GYN physicians may opt for a general practice or choose to continue their education and become specialists. There are four fields of sub-specialty for OB/GYN which include (1) gynecologic oncology, (2) reproductive endocrinology & infertility, (3) maternal & fetal medicine, and (4) urogynecology & reconstructive pelvic surgery.
• Obstetricians and gynecologists also attend meetings and workshops which boost their skills, knowledge, and consequently skill levels. Some training recently scheduled for attendance by obstetricians and gynecologists cover "advances in OB/GYN ultrasound," and developments in neuroelectronic interfaces, etc.
• Institutions such as the American Institute of Ultrasound in Medicine, Orlando Health, and Wake Forest School of Medicine are known to organize some training sessions advancing ultrasound techniques in obstetrics and gynecology for physicians and technicians. Ultrasound imaging is used to manage "chronic pelvic pain in women."

RESEARCH STRATEGY

CONFIDENCE LEVEL OF ANESTHESIOLOGISTS IN PAIN MANAGEMENT

• The confidence level of anesthesiologists in pain management can be described as very high. This optimism is based on the words of the clinical professor of cardiothoracic anesthesiology at the David Geffen School of Medicine at UCLA, who states that "from the clinical work of chronic pain management to being in the labor and delivery room to care for mothers and neonates, we can do it all."
• Anesthesiologists believe in the specialty of their profession and do not hinge it on general understanding, hence the reason an anesthesiologist can be compared to an airplane pilot. Anesthesiologists do not feel uneducated; after bagging a 4-year degree, they complete 4 years of training after medical school.
• Because pain management can be complex and can cause non-desirous effects if not properly administered and monitored, it is recommended to consult with an anesthesiologist who specializes in pain management. This goes to suggest the level of confidence the body of professionals has in their craft.
• Anesthesiologists understand how pain works in the human body as they have come up with two types of treatment for such; one which involves opioids drugs and the other which is devoid of non-opioids drugs.
• There are shared stories from patients, physician anesthesiologists, and other physicians of how anesthesiologists were able to put lives back on track with treatments that are based on their understanding of how pain works in the human body.
• Anesthesiologists undergo a four-year residency program after medical school which forms a crucial part in their learning process and where confidence in the profession as a pain manager is built. According to the ASA, "it requires a physician who has the extensive medical education (up to 14 years) and clinical training (12,000-16,000 hours) to evaluate your medical condition, recommend an appropriate anesthesia plan, diagnose and treat problems that might surface during a procedure, and make critical, split-second decisions that can save your life."
• The ASA, as the body that regulates the continuing education of anesthesiology, has guidelines towards continuing education for professionals in the field through its education center, research and publications, meetings, seminars, and workshops.

HOW DO ANESTHESIOLOGISTS VIEW PAIN MANAGEMENT?

• The ASA strongly recommends patients to consult with anesthesiologists who specialize in pain management against self-medication because of complex and undesirable effects of self-medication if not properly administered and monitored.

• The role of the patient is to seek a physician anesthesiologist and not take to self-medication.
• Other roles of the patient include disclosure of his health habits and medications to his physician anesthesiologist, discussion of his/her use of alcohol and hard drugs/stimulants with his/her physician anesthesiologist, share his/her experience with anesthesia, share his/her fears with the physician anesthesiologist, and discuss his/her recovery process with the physician anesthesiologist.
• The roles of a patient also include following pre-surgery directions and diet, bringing a friend to take him/her home after surgery, and putting on a comfortable cloth such as loose-fitting clothing to cover up possible swells post-surgery.

• The role of the physician anesthesiologist is to work with the patient's other physicians like oncologists or surgeons depending on the pain in question.
• Other roles of the physician anesthesiologist include performing the patient's complete physical examination, asking the patient to describe his/her pain for fact-finding purpose, asking the patient to fill out a detailed questionnaire about nexus of the pain with his/her life, reviewing the patient's medical records, X-rays, and other images, and ordering for tests for proper diagnosis and treatment.

OB/GYN SURGEONS’ OPINIONS AROUND PAIN AS IT RELATES TO COSTS

• OB/GYN surgeons consider drugs they prescribe based on cost.
• The surgeons try other pain medication and management that are equally (or almost equally) effective but less pricey and so they try to eliminate the use of expensive medication.
• In light of this, the surgeons try to implement high-value care projects on performance improvement.
• After experts at Greenville Health discovered the effectiveness of less expensive pain medication over Epifoam, Epifoam orders dropped by 90% from 2,287 to 228 times annually. The removal of Epifoam by this hospital saved it $92,655, not to mention the cost saved by the patients.
• Another expensive drug, Cervidil, was first highlighted and its use dropped from 384 to 194 cases saving $66,500 and then it was completely ruled out.
• Nevertheless, their prescriptions may not always be influenced by cost, considering that OB/GYN surgeons have been accused of overprescribing opioids after all kinds of surgeries and therefore prescribe these kinds of products more than others.
• The number of drugs prescribed by surgeons does not consider the associated costs because, at the 46th AAGL Congress, it was discovered that out of an average of 29.6 opioid tablets, 19.1 were leftover (or wasted) regardless of the type of surgery.
• Surgeons believe that patients should thoroughly discuss their postsurgical pain medication and management before surgery.

OB/GYN SURGEONS’ OPINIONS AROUND PAIN RELATING TO PATIENTS GETTING DISCHARGED

• OB/GYN surgeons opt for preoperative to postoperative pain medication and management to help patients get discharged faster.
• In addition, multimodal pain management strategies covering intraoperative, preoperative and postoperative pain management and medication are discussed with the patient which can reduce patient's stay in the hospital.
• The surgeons are more likely to prescribe an opioid alongside another analgesic for discharged patients to take at home.
• OB/GYN surgeons are concerned about the leftover pain medication for discharged patients and therefore might tend more to delaying discharge until the amount of leftover medication is considered minimal.

RESEARCH STRATEGY:

OB/GYN Surgeon Persona: Technology Adoption

• Obstetrics and gynecology surgeons embrace new technology by increasing the efficiency and accessibility to the utilization of technology to carry out minimally invasive surgery.
• Michelle D. Edwards, Director, MedTech says that women in the United States have suffered from benign uterine tumors. As a result, new technology was adopted to treat uterine fibroids noninvasively.
• However, no such technology existed for so long but with the new therapy alone, women can be prevented from living with severe pain and/or heavy menstruation when undergoing a hysterectomy. Thus, the new technology was well-positioned to become the standard of care for treatable patients.
• Expanded use of new technology has been suggested as a possible strategy for mitigating demand for delay for obstetric–gynecologic surgery.
• Gynecology surgeons show distinct needs and barriers when it comes to adopting new technologies.
•  Virtual/augmented reality helps to reshape medical training by allowing doctors to overlay information or images in the world right in front of them. Nearly three-quarters of Obstetrics/Gynecology specialists indicate they are likely to use Virtual/augmented reality within the next five years (2023).
•  Robot technology is applied widely in gynecology for hysterectomy, sacrocolpopexy, myomectomy, adnexal surgery, and malignancy staging. Thus, the field of robotic surgery has developed rapidly, and its use for gynecologic conditions has grown exponentially.
• OB/GYN Surgeons generally perform up to 90% of all GYN surgeries in the United States.
• The new techniques and procedures, or new procedural technology developed by CIGC prove that there is a better way to perform GYN surgery from a both clinical and financial standpoint.

Correlation — Adoption Rate and Using New Products in Medical Practice

• As per the American Congress of Obstetricians and Gynecologists, there has been an increase in the number of female physicians in training and practice for surgical specialties. In a period of the rapid growth of medical knowledge, advancement in technology, and emphasis on health care provider competencies, subspecialization appears to be desirable for patients.
• Dr. John M. Garofalo, M.D., the first gynecologist in Fairfield County says he has been regularly adopting new technologies during his surgical experience.
• DualPortGYN hysterectomy and LAAM procedures are safer, faster, and cheaper to perform in the outpatient ASC setting, and have higher patient satisfaction rates than any other type of hysterectomy or myomectomy nationally or internationally.

RESEARCH STRATEGY

ANESTHESIOLOGISTS ADOPTION OF NEW TECHNOLOGY IN THE U.S.

• According to a publication by the National Library of Medical Science, anesthesiologists in the United States are early adopters of new technology in their field and are encouraged to continue this trend which means that it is likely that they will use new products.
• The publication also states that anesthesiologists "tend to be comfortable incorporating technological solutions to improve patient care." This further supports the likelihood that they will use new products.
• Between January and August 2019, 22 new technological inventions and innovations in the field of anesthesiology (some of which have already gone through a trial) have been published by Medgadget (a credible medical technology news site) as cleared by the FDA (the Food and Drug Administration of the United States of America). Following the trend, there is a likelihood that anesthesiologists will continue to use new products in their medical practice, as long as it is has gone through the necessary trials and been approved.
• The field of anesthesiology has the Society for Technology in Anesthesia (STA) and even though it is an international organization it has its headquarters in Milwaukee, U.S. Its mission is "to improve the quality of patient care by improving technology and its application." This is another proof that anesthesiologists are interested in technological improvements and applications in their field and could use new products.
• Anesthesiologists typically adopt new technologies and they must continue to do so for crucial reasons like satisfying patients who "use technology to manage their well-being", also called "digital patients". There are other important reasons like "simplifying work processes, providing solutions for clinical decision-making and the delivery of healthcare in the Perioperative Surgical Home (PSH)". These reasons and the need for continual improvement show that there is a likelihood that anesthesiologists will use new products.
• This field of medicine is being re-defined by the emergence of new technologies, so the present-day anesthesiologist is left with no choice but to become tech-savvy and beyond that "understand healthcare technologies and how to best leverage them to improve patient care and outcomes". Since there will be continual advancement and application of medical technology, it is only logical to conclude that anesthesiologists will not refuse to use newer innovations or products in their field.

 Free Drug Samples 

• Pharmaceutical companies spend billions annually, distributing free drug samples to physicians.
• Physicians are likely to prescribe newer expensive drugs even when there are cheaper alternatives in the market.
• Physicians who receive free samples use them on their patients with limited risk.

 Meeting with Sales Representatives 

• Sales representatives from pharmaceutical companies inform physicians of new drug launches and their benefits.
• Physicians are more likely to purchase drugs if they have an interpersonal relationship with sales representatives from the company.
• Pharma companies need to build good relationships with physicians to increase their sales.

 Using Social Media 

• Pharma companies target online social platforms that have numerous subscribers to market their new products. An example is Physicians Interactive (PI) which has an online and mobile network of over 875,000 medical specialists, nurses, and physicians.
• Another online platform is Sermo. It is an MD-only platform with over 115,000 members and provides an opportunity for pharma companies to interact and market their new products to physicians.
• Drug companies are also using social media to promote their products.
• Physicians are more into medical apps that other digital and print publications.

 Medical Conferences 

• These conferences provide an opportunity for pharma companies to interact with physicians and get feedback on their products.
• Some of the medical conferences that have been held/are scheduled to be held in 2019 in the US include DCAT 2019, PCC 2019, CPhl North America, ASCPT 2019 Annual Meeting, and ASCO 2019. These conferences allow physicians to learn about new trends and drugs in the industry.

 Medical Journals 

• Medical journals provide an opportunity for pharma companies to precisely target different physicians with their new products.
• Some of the most popular medical journals among physicians include Medscape (40%), Journal of the American Medical Association (28%), Medical Economies (22%), and Mayo Clinic Proceedings (12%).
• The top OB/GYN journals include Human Reproduction Update, Human Reproduction, Obstetrics and Gynecology, Ultrasound in Obstetrics and Gynecology and Gynecologic Oncology.

RESEARCH STRATEGY

USEFUL FINDINGS

• In 2019, the American Society of Anesthesiologists (ASA) launched a new Opioid Analgesic Risk Evaluation and Mitigation Strategies (REMS) continuing medical education (CME) course available for Anesthesiologists.
• The ASA course was aimed at helping Anesthesiologists mitigate the opioid crisis through education on appropriate prescription, best practices for managing pain and opioid alternatives.
• In 2018, NCBI published an article on recent advances in intravenous anesthesia and anesthetics which mentioned some innovations in drug development.
• Drugs.com is an online pharmaceutical encyclopedia which provides drug information for healthcare professionals.
•  UpToDate is one of the medical educational support resource associated with improved outcomes and provides the most recent medical information. The website also gives the latest updates in Anesthesiology.
• The Pain Management division of Department of Anesthesiology of Cornell.edu offers a full spectrum of treatment options for Anesthesiologists for preventing and treating both acute and chronic pain.

Research Strategy

ANESTHESIOLOGISTS- OPINIONS AROUND PAIN AS IT RELATES TO COST

• Anesthesiologists are interested in reducing surgical costs by inducing patients with local anesthesia. 
• Anesthesiologists consider low-cost local anesthesia (neuraxial anesthesia) to reduce the operational costs of surgeries like knee or hip replacements which reduce 17-19% of hospitalization costs.
• They consider insurance coverage of patients while prescribing an anesthesia plan. For instance, they prescribe home-going catheter for pain management based on patient’s insurance coverage.

ANESTHESIOLOGISTS- OPINIONS AROUND PAIN RELATING TO PATIENTS GETTING DISCHARGED

• Anesthesiologists suggest discharge after evaluating control over pain by prescribing the pain medication. They prescribe pain medication based on individual patient condition.
• Most of the anesthesiologists in the US are practicing ambulatory anesthesia method based on which patients can be discharged early after surgery.
• Ambulatory anesthesia is considered beneficial because it helps to reduce the cost of patients hospitalization cost.
• Additionally, anesthesiologists also prescribe some non-opioids such as ibuprofen, acetaminophen, and aspirin as well as suggest other pain management methods such as acupuncture for outside of the hospital setting treatments to take at home.

Research Strategy