Nerve blocks provide alternatives to opioids

Dr. Christian Becker, Mountain View Hospital’s director of anesthesia services, poses for a photo June 13 with an ultrasound machine used when administering a nerve block. Becker uses a cocktail of medications to extend the nerve block for up to three days to help patients cope with pain instead of prescribing larger amounts of addictive opioids. John Roark / jroark@postregister.com

Epinephrine, Bupivacaine, Decadron and Exparel — medications that make up a longer lasting nerve block — are seen on June 13. Dr. Christian Becker, Mountain View Hospital’s director of anesthesia services, uses the cocktail of medications to extend the nerve block for up to three days to help patients cope with pain instead of prescribing larger amounts of addictive opioids. John Roark / jroark@postregister.com

The fear of addiction pulsed through Michael McGurk’s veins, but in the hours after his surgery narcotic pain medications didn’t.

Many people worry about becoming addicted to opioids following a surgery. Prescription use of opioid painkillers are one of the many ways people can become hooked.

But surgical nerve blocks and localized numbing medications are helping eliminate the need for opioids after surgery.

Surgeons and anesthesiologists are recognizing the need for alternatives to the opioid painkillers that may lead to pill-popping down the road. One alternative medical professionals are starting to utilize involves using numbing techniques more heavily during surgery.

The anesthesiologist will administer a nerve block, or numbing medication, at or around the surgical site to help decrease the need to opiates after surgery. The nerve block lasts anywhere from 24 to 72 hours, depending on the type administered.

“The longer we can control the pain with the injection, the less we have to rely on the narcotic medications after,” said Jason Dalling, an orthopedic surgeon in Idaho Falls who utilizes the numbing medication.

The numbing techniques help patients get through the acute period of pain after surgery where they would traditionally be relying heavily on opioid medication. The block allows patients to get through this period without opioids and helps jump-start the recovery process.

“If you just took the first 72 hours after surgery, the patients are more coherent, get up early, move more comfortably earlier in the game,” Dalling said.

During surgery, Dalling injects a cocktail of numbing medication into the surgical site, which gives him the ability to tailor the numbing technique to each patient.

And this is what McGurk had done.

McGurk had surgery in the past without a local numbing agent before and had to rely on opioids after surgery to manage his pain. He didn’t like it, and was worried about the implications of taking an addicting drug.

“I was on multiple drugs, two different opiates and things just got out of hand. There was definitely a lot of pain involved,” McGurk said. “ (I) ended up taking way too much. It got me into a very uncomfortable situation.”

But during his second surgery with Dalling, McGurk received the numbing medication and it made a huge difference for him. He said he didn’t know if the physical recovery was any different, but he liked that he didn’t have to rely on addicting drugs to manage the pain.

“Things were smoother, I was more clear-headed,” McGurk said. “(I) just wasn’t sitting popping pills every 3 to 4 hours.”

Christian Becker, Mountain View Hospital’s director of anesthesia services, administers nerve blocks for surgeries with his team.

Before Becker’s arrival, nerve blocks weren’t really utilized in the hospital. The technique was part of Becker’s training at the University of Utah and he started advocating for it after he arrived in Idaho Falls. Today, he does about 50 nerve blocks a month for surgeries.

And that number is anticipated to keep growing. Becker wants to expand the anesthesia services staff so he can increase the nerve blocks he does. Right now he’s having to turn people away because he can’t get to them all.

He said with the increased attention on opioid use, a lot of people are looking for alternatives to control pain.

“In general, because there’s been such a focus on this (opioids) now nationwide,” Becker said. “I think it’s a really positive things because now every hospital is now going to start, if they haven’t been doing it. They’re going to start looking.”

Part of the process of reducing opioid use and abuse is talking to surgeons and making sure they’re aware of the alternatives to opiates and using them responsibly, Becker and Dalling said. Patients might still need opiate medications after the nerve block wears off.

“The longer we can control the pain with the injection, the less we have to rely on the narcotic medications after,” Dalling said.


Reporter Isabella Alves can be reached at 208-542-6711 or follow her on Twitter @Isabellaalves96


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