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Continuous nerve blocks provide longer, more effective pain relief for some types of surgeriesWhen Scott Hillesheim went down during a Cathedral football game, he was reasonably sure he had torn his ACL (anterior cruciate ligament). It is not an uncommon injury for such a sport and he had friends who had suffered the same. What is uncommon is the fact that, following his surgery to repair his ACL and some cartilage damage, he was able to go home the same day. The surgery generally requires an overnight stay. Hillsheim, and his orthopedic surgeon Mario DeSouza, MD, feel fairly confident that he was able to return home thanks to a new method of pain control called a continuous nerve block. New Ulm Medical Center began performing continuous nerve blocks in mid-August and is only one of a handful of facilities in the state that offer them. They are used primarily in total knee replacement surgeries, ACL repairs and shoulder surgeries. “The difference between this and intravenous medications is that the catheter is threaded into the sheath of nerves that covers the knee or shoulder,” explained Certified Registered Nurse Anesthetist Shirley Steele. The catheter then delivers a continuous drip of non-narcotic pain relief medication and the patient is actually able to control the level of medication being delivered. “It means the difference between eight hours of pain control and three days of pain control.” That can mean huge relief not only physically but mentally for patients, said orthopedic surgeon Jean Eelma, MD. “Major surgeries around the knee are very painful. One of the key things patients dread is what those first couple days following the surgery will be like,” she said. “This is incredibly effective as a way to reduce that pain.” In fact, Eelma said, since usage of the continuous nerve blocks began she has seen a definite decrease in request for pain medication prescriptions. That is the answer to another common problem following such surgeries: the fewer narcotic pain medications that are taken, the fewer undesirable side effects such as nausea, vomiting and constipation, Steele said. DeSouza feels a primary benefit is that continuous nerve blocks don’t interfere with rehabilitation. Patient Glenora Fick can attest to that. The independent 80-year-old Fick wanted nothing more than to get back to her regular activities as soon as possible following total knee replacement surgery in late August. She doesn’t recall having any pain with the continuous passive motion machine that knee surgery patients are all-too-familiar with following surgery. The machine gets the patient’s knee moving right away after surgery so as to begin physical therapy immediately. “I was in the hospital three days and then went to a nursing home for two weeks for rehabilitation,” Fick said. “The nurses there just couldn’t get over how well I was doing. I had both a walker and a cane and I used both very little and took very few pain medications.” Because the pain immediately following surgery can be better controlled with the continuous nerve blocks, DeSouza said, the physical therapy can be that much more effective in a timelier manner. That can make the difference for a speedier recovery, such as in Fick’s case. In some cases, such as Hillesheim’s, the patient can actually go home with the catheter still in place and they can continue to administer the desired amount of medication until the unit is depleted. “It was definitely working because I could tell when it ran out of medication,” Hillesheim said. The units themselves are very simple, Eelma said. “They are all self-contained and the patients can remove them themselves.” As for Hillesheim, he is glad to have such a successful ACL repair behind him and can’t wait to go climbing mountains on a previously-planned trip to Guatemala in January. |
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New Ulm Medical Center
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