most instances, your surgeon will order any needed post-operative
pain medication. However, when significant pain might slow recovery,
such as after chest, major abdominal or major bone operations, we
may be asked by your surgeon to perform certain special procedures.
These techniques include spinal, epidural and nerve blocks.
If your surgeon
has requested one of these techniques, your anesthesiologist will
discuss the procedure with you including the expected benefits and
It is important
to keep in mind that no technique, procedure or medicine is capable
of totally eliminating all post-operative pain or discomfort. Our
goal is to combine medicines and procedures in order to make you
as comfortable as possible and facilitate your recovery from surgery.
your anesthetic, a small area of your lower back is numbed with
local anesthesia. A small needle is passed through the numb area
into the spinal fluid. A narcotic, usually morphine, is then injected
and the needle is removed.
Using this technique
can provide long lasting (18-24 hours) post-operative pain relief.
The pain relief is often better than that of intravenous (IV) or
intramuscular (IM) narcotic injections and usually causes less sleepiness
and other side effects.
is required in the post-operative period but this can be done on
the surgical floors.
management also begins before your regular anesthetic. After numbing
the skin, a very small plastic tube, or catheter, is inserted through
an needle in your back. The tip of this tube is in the epidural
space just outside the sack containing the spinal fluid and nerves.
Epidurals can be placed in either the upper or lower back depending
on the area of your operation.
catheter is attached to a battery powered pump which continuously
administers local anesthesia, sometimes mixed with narcotics. This
produces a band of numbness in the area of the surgical procedure
which can markedly reduce post-operative pain. In addition to pain
relief, this allows the patient to move, breathe and cough more
catheter can be left in place for up to 3 days after the operation.
As with spinal narcotics, special monitoring is required while the
catheter is in place.
Prior to starting
your regular anesthetic, the skin will be numbed and light sedation
is administered. A needle attached to a battery powered nerve stimulator
is then inserted toward the nerve bundles controlling pain sensation
from your arms or legs. When the needle is near the appropriate
nerve, muscle movement is seen in the desired area.
is then injected through the needle or a catheter is placed for
post-operative injection. This will produce pain relief in the operative
area. Depending on circumstances, pain relief can be continued for
2 or 3 days post-operatively.
of the arm, the needle or catheter is usually placed in the neck
for shoulder surgery, or in the chest or armpit for arm or hand
of the leg, the needle or catheter is usually placed in the groin,
buttocks or behind the knee.
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