For decades, opioids have been used to treat patients during surgery and help them manage their pain when they return home from the hospital, but as more people in this country get hooked on the powerful painkillers, a D.C. hospital is turning to an alternative whenever possible.
Instead of opioids, anesthesiologists like Dr. Andrei Cernea at Sibley Memorial Hospital are turning to nerve blocks for total joint replacements; abdominal surgeries like appendectomies and hernia repairs; and thoracic surgeries involving the heart, lungs and esophagus.
A nerve block is a type of regional anesthesia that uses pain medication to numb the nerves only around the area that's being treated. Doctors say it’s safe and has fewer side-effects than opioids, not only allowing patients to recover more quickly, but reducing the risk of complications after surgery and sending patients home pain-free.
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“We essentially overnight started to see patients who were pain free at the end of their surgery and actually eager to engage with the physical therapy,” Cernea said. “They were eating right away, they were getting out of bed, and by day two, they were like, Why am I here?”
Once a patient leaves the hospital, most will use medications like Tylenol and ibuprofen for postoperative pain, Cernea said.
A big part of the program's success comes from educating patients and caregivers before they go under the knife.
“Hearing the term ‘nerve block’ is kind of scary to people but if you can explain to them, it's longer acting, you'll be numb, you'll use less narcotics, you’ll have less nausea,” said Cindie Wade, a nurse who has seen Sibley’s program evolve over the past eight years.
She said other hospitals have sent nurses to observe their program and may soon follow Sibley's lead to fight the opioid epidemic.
This may not be an option for everyone. People who need opioids as part of their cancer treatment or have become dependent on opioids for their pain therapy would not be good candidates for this. The hospital said it depends on the patient and their medical history.