AT-HOME ANESTHESIA
While surgery is not easy, it's the recovery afterwards that can really take its toll on a patient. In the past, patients have been sent home with narcotics to relieve pain, but the drugs can have negative side effects. There's an option that makes recovery at home easier.
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Mary Young and her husband Frank are relaxing at home, just one day after Mary had shoulder surgery.
Mary Young
Had shoulder surgery
"It was hurting bad enough that I said, 'I want it fixed.'"
Surgery made mary nervous, but the recovery worried her more. Pain pills and mary are old enemies.
Mary Young
"I was nauseated, very sick, sleep for two or three days and just felt really bad."
This time around, Mary is free from those strong narcotics. Instead, she's hooked to a pump that delivers a local anesthetic to keep her shoulder numb.
Mary Young
"I don't have any pain at all."
Anesthesiologist Ward Longbottom says at-home anesthesia is a huge step forward for patients.
Ward Longbottom, M.D.
Anesthesiologist
University Community Hospital
Tampa, FL
"A lot of the operations that did have to stay in house in the past are now going home."
Doctors use a stimulator to find the nerve that needs to be blocked. A catheter is inserted in the skin and is hooked to the pump.
Ward Longbottom, M.D.
"When the patient goes home, they have 24-hour-a-day access to an anesthesiologist."
Doctor Longbottom also says the anesthetics used are less toxic and safer for the patient.
Mary gets a continuous dose of pain relief.
And with a simple push of a button, she can get more medication and more relief. But the programmed pump will not go above the amount set by the doctor.
Mary Young
"I have felt so much better."
Mary hopes her road to recovery will be as smooth as the first 24 hours.
The at-home anesthesia is available to patients who have surgery on their arms or legs. For example, it's used for shoulder, elbow, wrist, knee, hip or ankle surgeries. Doctors say another benefit is patients who are in less pain often have better rehabilitation.
BACKGROUND: Besides the fear of surgery, another reason people avoid surgery is because of the recovery process. As the number and types of outpatient surgeries increase, so does the need for safe, effective, at-home pain relief strategies. A recent survey found 40 percent to 70 percent of patients experience severe pain after surgery. Patients are often given oral narcotics to take when they go home to help with the pain. The problem is these drugs can cause bad side effects including nausea, vomiting, constipation, disorientation, sleep disturbances and itching. Now, patients may have a new choice for pain management. Some hospitals are offering patient-controlled regional anesthesia. PCRA is available because of improvements in nerve mapping, convenient pumps and less toxic drugs.
PCRA: PCRA, also called "at home-anesthesia," provides site-specific analgesia with minimal side effects. In order for it to work, doctors use advanced techniques in nerve mapping. A stimulating catheter allows for accurate location next to the nerve that needs to be blocked. The catheter is inserted two inches under the skin. It is hooked up to a small, convenient pump that patients can take home.
The pump can be worn around the patient's neck or around their hips like a fanny pack. The pump replaces the need for an IV stand. Doctors say new medications are also helpful because they are less toxic and safer for the patient. The pump is programmed by the doctor before the patient leaves the hospital. A continuous amount of the drug is pumped into patients, and they can request more by pushing a button. The pump will not give more medication than programmed by the doctor.
MAKING IT SAFE: Ward Longbottom, M.D., from University Community Hospital has had about 100 patients using PCRA. So far, he has not noticed any complications with the patients on the pump. He says it's important for the patient and caregiver to be trained before they leave the hospital, so they can detect any problems. He also says the patient can call the anesthesiologist 24 hours a day if they have questions. The doctor or nurse is also required to check on the patient at home twice a day while on the pump.
Dr. Longbottom says studies show PCRA not only reduces hospital stays, but also improves rehabilitation because the patient is in less pain. Dr. Longbottom says all of the pieces of the puzzle have finally come together to make a huge improvement for patients who go home after surgery and still have pain.
Health Source at University Community Hospital
Tampa, FL
(800) 326-4325
Copyright © 2004 Ivanhoe Broadcast News, Inc.
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