Blocking pain after outpatient surgeries without the use of opioids

As more scrutiny is put on opioids, doctors are looking at better ways to control pain. We look at how updated techniques are making more advanced outpatient surgeries possible.

A spinal fusion was once exclusive to a hospital operating room, but with advances in pain control, many people are undergoing complex surgeries as out-patients.

Dr. Jeffrey Henn is a neurosurgeon with Joint Implant Surgeons of Florida. He said, “When you add good anesthesia with minimally invasive, you essentially have the opportunity in the right patient to then take what would otherwise have been a hospital-based surgery and move it into the surgery center world.”

Henn is having success with outpatient fusions while keeping his patients off opioids.

“They have addiction potential, but they also tend to make people potentially have nausea, vomiting, etc.” Henn explained. “So it’d be hard to send somebody home when you’ve just given them opioids.”

Operating through small incisions using specialized tools, makes it possible. One of the newest advancements is an erector spine block that directly bathes the nerves with anesthesia.

“The anesthesiologist does this before the surgery, they put it into the region around the spine and it has the same goal, to make that area numb or at least more comfortable,” said Henn, explaining the procedure. “So that’s allowed us to also do bigger and bigger surgeries and have a patient in the recovery room saying either no pain or mild to moderate pain, again, to the point where they say, ‘yeah, I feel comfortable, I feel like I can go home.'”

He said blocks are used along with enhanced versions of over-the-counter inflammatories. “The idea is you’re using a combination of treatments and trying to control the pain pathways using three or four different techniques all at the same time.”

The end result is well-managed pain, fixing a problem, without the fear of addiction.

These same pain management methods are used whether or not the patient goes home the same day, but it allows more operations to be performed without an overnight stay and saves patients money.