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Method May Change Pain Management

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Method May Change Pain Management

December 20, 2000

By Sheila Dwyer, MedTech1 Staff

Patients who undergo major orthopedic surgery, such as joint replacement, may suffer frustrating post-operative pain. Despite the pain, quick rehabilitation after surgery is in the best interests of these patients and their joints. However, many post-operative orthopedic patients react poorly to the morphine-like drugs that are traditionally administered. The grogginess that can accompany these drugs is not conducive to speedy rehabilitation.

Continuous regional anesthesia is a method of postoperative pain relief that has gained in popularity over the past 5 years. Its appeal lies in its ability to provide pain relief without narcotic side effects to patients who are recovering at home following major surgery.

HDC Corporation of San Jose, CA, recently released the CLA Kit, which is used for performing continuous regional anesthesia nerve blocks in patients who require post-operative pain management.

Tim Duvall, COO of HDC Corporation, says that the CLA Kit is “really a continuation of our activities in the whole peripheral nerve block arena.” The peripheral nerves are the nerves outside of the spinal cord and brain whose impulses are interrupted by the administration of a local anesthesia in preparation for surgery. HDC’s CLA Kit takes the idea of regional anesthesia during surgery one step further.

The CLA Kit provides the patient the analgesic benefit of continuous regional anesthesia following surgery. The idea is, according to Duvall, that “the patient is now going to be ready for discharge from the hospital. Is there a way to continue a regional, a peripheral, block on a continuous basis to provide pain relief so that we don’t have to resort to narcotics and other drugs that somewhat limit the patient’s ability to move or to actually recover?”

According to Duvall, “the bulk of this technique will find itself in orthopedics at this time.” Indeed, most of the research done on continuous peripheral blocks and continuous regional anesthesia involves joint-replacement patients. In some cases, continuous regional anesthesia has allowed doctors to perform joint replacement surgery on an outpatient basis with greater pain relief and fewer complications. Some physicians have noted that a decreased need for narcotic medication means fewer gastrointestinal problems and fewer general complaints from patients.

Duvall understands the urgency of early recovery and rehabilitation for certain orthopedic patients. He explains, “When you’re trying to help a patient, and especially an orthopedic patient, you want them to become mobile pretty soon. They have to go through physical therapy right away in order for the recovery process to be a positive one. General narcotics tend to limit the patient’s mobility … So this procedure (continuous regional anesthesia) places the drug only in that localized nerve center so they can actually begin physical therapy right away.” People who have gone through joint replacement surgery can appreciate the importance of moving the joint shortly after the procedure. Patients who have stiff joints several days after surgery are less likely than their pain-free counterparts to want to move them.

The CLA Kit features several tools for the anesthesiologist administering the continuous regional anesthesia. The Tuohy insulated needle and the Neuro-Trace II nerve locator assure the anesthesiologist of a high success rate for peripheral nerve blocks. A catheter comes with the kit as well and is put in place via the insulated needle. The catheter continuously administers anesthetic over an extended period of time. The CLA Kit also contains several securement clips to hold the devices in place.

HDC Corporation is pleased to find itself in the emerging field of continuous regional anesthesia. In discussing the CLA Kit, Duvall speaks to orthopedic patients frustrated by the way narcotics have slowed them down following surgery. “If they (peripheral nerve blocks) can actually stop the pain for a while, a lot of times that aids in the healing process and gets the patient’s mindset to where they don’t experience the pain.”

For more information on CLA Kits, visit HDC Corporation’s Web site. References:
www.esraeurope.org
www.aofas.org

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