Health

Device Promises Better Pain Relief After Surgery

(WCCO) Every year 300,000 Americans have knee replacement surgery. Many more should have it but put it off because they fear the pain and long, grueling recovery. Some also fear the side effects of pain-fighting narcotics.

"Their pain isn't even very well covered by narcotics and then they're not able to participate in physical therapy afterwards, which is very critical for a good outcome from a knee joint replacement," said Twin Cities anesthesiologist John Mrachek, M.D.

"Skeets" Langley was among the group of patients stalling much needed knee joint replacement. He said he let his arthritic knees get so bad he was shuffling along like comedian Tim Conway in an old Vaudeville skit.

However, eventually Langley agreed to try a pain control procedure gaining popularity. It is the use of a continuous nerve block system, made by I-Flow Corporation, called the On-Q C-bloc.

For a knee replacement, the tip of On-Q's flexible catheter is inserted at the groin. A simple, adjustable meter delivers the right dose of numbing fluid to the femoral nerve with a slow steady drip.

"It would lay right next to the nerve," said Mrachek. "That is to target the pain relief directly to the nerves that are sending the pain signals to the brain."

Only sensation to the leg is affected.

After the On-Q pump is removed two to five days later, patients still report less pain.

"I can't vouch for anyone else's postoperative pain, but I had none. None," Langley said.

Mrachek also said blocking pain before the trauma of surgery seems to diminish the body's process of stiffening and inflammation around the joint. That lets patients more aggressively pursue their rehabilitation.

Langley seemed to be proof of that. Just one week after his operation, Langley said he was back on the rowing machine in his basement gym.

"The first time I went into physical therapy, they were amazed at the range of motion [I had] right off the operating table," Langley said.

A study of 200 patients, whose first knee replacement was without On-Q, reported a greater range of motion, quicker recovery and rehabilitation and a decreased use of narcotics after their second surgery with the device.

At Abbott Northwestern Hospital in Minneapolis, Mrachek said the potential benefit is huge in the surgery center which performs an average of 125 operations a day.

Nationally, the On-Q pain pump has been used for numerous procedures other than joint replacement, including gastric bypass, prostate and cosmetic surgery.

Langley's confidence in it was clear just two days after his first knee replacement. While still in the hospital he scheduled the same procedure for his other knee.

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