Innovative Pain ManagementMay 01, 2013
New England Baptist Hospital has pioneered innovative guidelines for managing pain during joint surgery. It involves preventing pain before it starts and minimizing the amount of narcotics used. This program is one of the reasons joint replacement patients at NEBH are able to begin rehabilitation earlier, meet their in-hospital therapy goals, go home sooner, and are happier with their overall experience during their hospital stay.
Fewer Narcotics Reduces the Risk of Complications
The goal of pain management during joint surgery is to minimize pain during and after surgery. At NEBH pain management team uses much less narcotic than past standard practice, so patients are largely spared from experiencing side effects such as grogginess, nausea and vomiting that often accompany narcotic use. Doctors at NEBH also found that by removing patient controlled pain relief systems, complications including respiratory depression (slowed rate of breathing), respiratory arrest (when breathing stops), and intubation (inserting a tube into the mouth to assist with breathing) was reduced.
Pain Management Protocol
Doctors at NEBH reviewed science and best practices and designed a complex pain management protocol that includes:
- a pain management “cocktail” of medications, customized for every patient, taken prior to surgery
- ultrasound guided nerve blocks for knee replacement and other joint procedures, which relieve pain by injecting long acting local anesthetics around nerves
- targeted local anesthetic injections during surgery
- postoperative oral pain medications which target different nerve receptors
- postoperative pain consultation if needed
This pain control protocol at NEBH has been very successful in keeping patients comfortable and safe from the complications of excessive narcotics, and in getting them home sooner. Since its inception, there have been no episodes of respiratory arrest and intubation due to narcotics. In addition, the average length of stay for all hip and knee replacement patients has dropped, and patient satisfaction rates remain among the highest in the country.