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Physicians with Anesthesia Medical Group provide acute pain management services to patients
during and immediately following surgery.
Pain control after surgery
contributes to the healing process. If pain is not adequately
controlled following surgery, patients may not be able to do the things
required to heal satisfactorily, such as taking deep breaths or getting
out of bed and walking. Pain and resulting inactivity can lead to
severe problems such as pneumonia or blood clots.
Many techniques are
available that can help patients achieve high levels of comfort and
safety following surgery.
Because the degree of pain
varies greatly from patient to patient, a technique or procedure that
might work well for one patient might not be effective for another. Our
physicians recognize that the needs of patients vary so they tailor
treatment approaches for each individual patient.
Techniques include
oral medicines, nerve blocks, continuous epidurals, spinal blocks and
narcotic infusions.
With the Intravenous
Patient-Control Analgesia (IV PCA) pump, the patient has greater
control over their pain. While the pump can be programmed to provide a
certain level of continual pain relief, it can also allow a patient to
increase pain medicine, within pre-set limits, by pushing a button.
Many people find that they need less total medicine with a pump because
they can control doses as needed.
During regional analgesia a
specific area of the body is targeted for pain relief. This type of
pain control involves placing a needle near nerves supplying the
affected area and then injecting a long acting local anesthetic. The
needle placement usually can be done under sedation. Parts of the body
that are amenable to nerve blocks include shoulder, wrist, hand, ankle
and foot.
Epidural analgesia delivers
anesthetic medication to nerves within the epidural space in the
vertebra. We place a small tube or catheter so medication can be
administered throughout surgery and beyond for comfort. After surgery,
a pump can be attached which provides a continuous stream of
medication. Frequently the patient can be given control over the dosing
mechanism just as with the IV PCA.
We call this technique the
patient-controlled epidural analgesia, or PCEA. This type of pain
control is particularly well suited for major lower extremity
procedures such as a total hip or knee replacement, certain abdominal
or pelvic surgeries and childbirth. This technique is also especially
useful following chest surgery.
When the surgical procedure
is performed with a spinal anesthetic, a long acting narcotic is
frequently added to the spinal medicine. This allows for pain relief in
the immediate post operative period. Intravenous or oral medication
will be provided when the spinal narcotic begins to lose effectiveness.
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