This column will appear in the upcoming April print issue of Surgical Products.
Most patients coming to Stamford Hospital for surgery are focused on what will take place in the operating room and give less thought to what happens immediately afterward. However, the healing that begins in the hours and days following surgery is an important step on the road to recovery. The ability to carefully and effectively manage pain after an operation can help reduce a patient’s hospital stay and get them back to normal activities more quickly.
Post-operative pain is not uncommon; approximately 70 percent of the people who undergo surgical procedures each year may experience pain after surgery. (1) If post-operative pain is ineffectively managed, it could potentially lead, in the long term, to poor wound healing, insomnia, pneumonia, pulmonary embolism, or other conditions. In addition, post-surgical pain may be a risk factor for the development of chronic pain. Preventing and/or relieving post-operative pain may help avoid these complications while improving a patient’s quality of life.
Until recently, post-surgical pain was primarily treated with narcotics, which data overwhelmingly suggest may pose the risk of dependence and addiction. Narcotics can also contribute to longer hospital stays, unnecessary readmissions, and increased potential for adverse drug events. Narcotics also have a whole list of unpleasant side effects for patients, including nausea, vomiting, and sedation. These side effects can potentially delay recovery times and have a significant impact on healthcare costs. As a result, many hospitals are implementing narcotic reduction programs that aim to reduce or eliminate unnecessary narcotics for post-surgical pain management. Surgeons and anesthesiologists are increasingly utilizing local anesthetics, rather than relying solely on opioids, for post-operative pain management.
At Stamford Hospital, we do the majority of our surgical cases with nerve blocks and local anesthesia, meaning that the entire body does not need to be numbed. Instead, you just numb the part of the body that is having surgery, whether it be an arm, a leg, an abdomen, or a chest wall. For many of our patients, we use the ON-Q Pain Relief System to effectively manage pain after surgery by delivering a regulated flow of local anesthetic through an indwelling peri-neural catheter. The small, balloon-like pump comes in a portable carrying case, which may be clipped to a patient’s clothing, or worn over the shoulder, or around the neck. Patients can control the dosing for pain relief, providing them with an active role in their pain management and giving them the option to recover at home.
By treating pain at the surgical site with a non-narcotic local anesthetic, we have been able to reduce the reliance on narcotics to relieve our patients’ pain following surgery. This in turn reduces narcotic-related side effects and helps patients recover more quickly. By offering alternatives to narcotics, we can help make the recovery process easier and less painful for our surgical patients, and get them back to their regular activities faster.
In addition to the patient benefits, adopting a non-narcotic pain management system can help hospitals align with many of healthcare reform’s quality improvements, including increased patient satisfaction, patient safety, and overall cost reduction. On average, our patients treated with the pain relief pump go home from the hospital a full day sooner than when treated with narcotics alone and we see fewer readmissions due to post-operative pain. This has a significant impact on the hospital’s bottom line.
It’s important to be able to offer patients a variety of options for managing post-surgical pain – and help select the treatment that’s best for them. Hospitals should explore alternatives to narcotics when considering the best pain management treatment plan for their surgical patients. Non-narcotic options can help hospitals address their clinical and financial goals while making the surgical recovery process easier and less painful for patients.
1. Lanfranco AR, Castellanos AE, Desai JP, Meyers WC. Robotic surgery: a current perspective. Ann Surg. 2004;239(1):14.
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