Bimal P. Gandhi, MD, is a board-certified anesthesiologist at Inova Fairfax Hospital. He serves as the Medical Director of Regional Anesthesia Services at Inova Fairfax Medical Campus.
Recovering from surgery can be a painful process. Prescription opioid medications can help patients manage post-surgical pain, but they have a well-publicized dark side: The United States is in the midst of an opioid epidemic, and healthcare providers across the country – including Inova – are taking aggressive steps to reduce opioid prescriptions.
Those steps are important and necessary, but no doctor wants to see his or her patient in pain. Fortunately, we have other pain management tools to turn to. Regional anesthesia, also known as a nerve block, can provide pain relief for days or even weeks. For many surgical patients, nerve blocks can reduce opioid use and help them get back on their feet sooner.
What is Regional Anesthesia?
Anesthesiologists perform regional anesthesia at the time of surgery. We typically use a portable ultrasound machine that allows us to visualize a patient’s internal anatomy. This helps us quickly locate the nerves that transmit pain signals in the part of the body the patient is having surgery on. Then we inject a local anesthetic around those nerves, which leads to numbness. In healthy patients receiving minor surgery, such as repair of a torn rotator cuff, a single injection may be enough to relieve pain during the first 24 hours after the operation.
For patients undergoing more painful procedures, such as lung surgery or repair of a hip fracture, a catheter can provide ongoing relief as they heal. A pump attached to the catheter will continue to release anesthetic into the nerves over time. In some cases, we can replace the pump to keep the catheter working for up to 30 days. Anesthesiologists, surgeons and patients work together to decide which approach is right for each patient.
Nerve Block Benefits
Regional anesthesia has clear benefits. It’s been shown to decrease patients’ pain after surgery – and to decrease opioid use. Patients who receive regional anesthesia are typically up and moving around more quickly after surgery. That can help them make the most of physical and occupational therapy to regain function as soon as possible. In some cases, regional nerve blocks can even shorten the length of a patient’s hospital stay.
Unfortunately, regional anesthesia isn’t used as widely as it could be. In part, that’s because pain management after surgery often falls to the surgeon rather than to the anesthesiologist. Using nerve blocks during surgery requires an integrated approach: Anesthesiologists, surgeons and nursing staff must all understand its role in post-operative pain relief, and when to use it.
As the healthcare community continues to take steps to decrease opioid dependence and abuse, regional anesthesia is quickly gaining traction. To make the procedure more routine, I helped launch a formal regional anesthesia program at Inova Fairfax Hospital in 2015.
Now, more than 20 anesthesiologists at Inova Fairfax Hospital are trained to perform some of the most advanced nerve blocks for pain control. We perform an average of 4,000 injections each year and place more than 1,200 nerve block catheters.
Physicians are also turning to regional anesthesia to treat pain in patients who don’t require surgery, such as people with rib fractures and those who suffer from a hard-to-treat disorder known as complex regional pain syndrome.
We’re continuing to grow our program at Inova Fairfax Hospital so that we can help as many patients as possible recover and live with less pain. Contact Fairfax Anesthesiology Associates to learn whether regional anesthesia could help you.