By Barbara Norrie
Special Assignment Reporter
BLUE HILL — Seventy-five percent of those who began using heroin in the 2000s reported that their first opioid was a prescription drug. Addiction often starts with use, misuse or overuse of prescription opioid pain relievers.
So it’s worth noting that Northern Light Blue Hill Hospital’s anesthesia department now offers an alternative for post-surgical pain management. Blue Hill Hospital is the only hospital in the state north of Lewiston-Auburn that provides its patients with the option of a continuous peripheral nerve catheter to control pain after same-day surgery. By offering a non-narcotic treatment for surgical pain, reliance on narcotics is limited, if not eliminated.
Monica Coffey, a family nurse practitioner who works in wound care at Northern Light Blue Hill Hospital and also practices addiction medicine, reported that protecting the brain from trauma and “noxious stimuli” while avoiding exposure to opioids can help prevent addiction. Kelley Columber, Northern Light’s director of communications, said the catheter “limits and, in many cases, eliminates the need for narcotic use after surgery.”
The Blue Hill surgical and anesthesiology teams use the ON-Q Pain Relief System, manufactured by Avanos Medical Inc. The catheter, sometimes referred to as a pain pump or nerve block, is a small device with a length of tubing that delivers a measured dose of low-concentration local anesthetic (usually Ropivacaine, a non-opioid analgesic) to the nerves responsible for perceiving pain in an extremity. The anesthetic is stored in a flexible plastic reservoir, roughly the size of an orange, which is attached to a variable rate controller that allows patients to make small dosage adjustments according to their pain level. The catheter is placed using ultrasound and/or electric nerve stimulation.
This method has been widely used by hospitals in the past for pre-op and surgical care. Single-injection nerve blocks also have been administered to patients before discharge with good results.
Nerve blocks temporarily stop nerves from communicating pain responses to the brain. During an operation, this means the brain doesn’t respond to the surgery as trauma. This helps manage physical movement and muscle tension, making a surgeon’s job easier and keeping the patient comfortable. Patients using a nerve catheter post-surgery experience increased mobility, and are more able to participate in rehabilitation. It decreases acute pain, in turn decreasing the risk for chronic pain.
Blue Hill surgical patients who have had the nerve block catheter report it was an effective alternative to narcotics.
Orthopedic surgeon Dr. Bruce Hamilton-Dick spoke of the responsibility of medical professionals to protect their patients from harm and to inform them of the most effective treatments available.
“The one thing that people remember [about surgery] is discomfort…” he said.
Managing that pain without the use of opioids is one tool in the fight against addiction.
He credits the organization of the program to Laura Schneider-Look, Northern Light Blue Hill Hospital’s chief of anesthesia.
“After completing diligent research my team of Certified Registered Nurse Anesthetist (CRNAs) here at Blue Hill decided to work toward the goal of offering the continuous catheters to solve many issues associated with surgical pain,” said Schneider-Look.
“We [at Blue Hill] now feel that we are offering the very best service to our patients, and couldn’t be happier with the success of this program to date.”