Nerve block eases pain, nausea after knee replacement
Posted November 29, 2010 5:55 p.m. EST
Updated November 30, 2010 4:23 p.m. EST
As knee replacement surgery becomes more common, more people know the difficulty of recovery.
In order to avoid some of the pain and the associated medications that can cause nausea, more patients are choosing an option to block pain just where it hurts.
Suzanne Siedel, a nurse at Rex Hospital, had her right knee replaced about three years ago under regional spinal anesthesia.
Spinal anesthesia numbs just the lower half of the body. Siedel was not totally unconscious, she was just relaxed.
For post operative pain, patients who opt to go that route typically have controlled access to morphine or other strong, narcotic drugs which often make patients feel too sick or weak to begin effective rehabilitation.
When Siedel had her left knee replaced last March, she had a different post-op plan for pain - a femoral block.
"Having the femoral block was much better," she said. "I'm an advocate of it."
Rex anesthesiologist Dr. Susan Steele uses ultrasound and exterior landmarks to help locate the femoral nerve in the leg. She then inserts a catheter to deliver the pain medication while the patient recovers in the hospital.
"We use continuous infusion of local anesthetics over three days," Steele said. "Those minimize the requirements for narcotics in patients."
With pain continuously controlled in the affected leg, there's still enough sensation to begin rehabilitation of the joint.
"They feel no pain, but also their mind is clearer," Steele said.
It's an option that allows patients to get back on their feet and back to work sooner.
Femoral blocks are not new, but Steele said newer equipment and improved ultrasound imaging makes it a more viable choice for post-operative pain relief in total join replacements.