Managing pain sets the tone for the entire experience for the patient after knee-replacement surgery, and can improve patient willingness to have the surgery.
“Pain management is really a big issue. That’s one of the things that keep patients coming in for the procedures. They hear horror stories about how painful it is afterward,” says Reed.
Over the past year, Stamford Hospital, Willamette Valley Medical Center, and others have used peripheral nerve blocks that improved postoperative pain relief and decreased recovery time without use of other narcotics following knee surgery.
Although no firm data has been established, Theresa E. Bowling, MD, associate chair of anesthesiology at Stamford Hospital, says patient satisfaction has significantly increased, according to preliminary figures. In addition, the hospital has been able to reduce anesthesia in surgery, with a 70% to 80% reduction in morphine requirements. The hospital also has reduced length of stay by 12 to 18 hours, she says.
“Since the inception of our continuous nerve block program we have seen a positive surge” in patient satisfaction, Bowling says. “We launched the program in November of 2008 and have successfully put in over 600 catheters to date with no complications.”
Before using the nerve blocks, patients were usually given general anesthesia, and intravenous narcotics that made them quite “uncomfortable with the general side effects,” Bowling says. “Nerve blocks are far superior for postoperative pain management, and we are tackling pain before the surgery starts,” she says.