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Podiatrist's Patients Remain Awake During Surgery, Yet Stay Pain-Free with High-Tech 'Pain Pump'
Quote:
When Dr. Peter J. Bregman performs surgery on a podiatry patient today, he attaches a small, microchip-controlled ambIT(R) infusion pump to a thin tube that bathes the nerves leading to the patient's foot in anesthetic. His patients stay awake during surgery involving an extremely sensitive area, yet remain completely pain-free. After surgery, the pain pump -- which hangs from a belt pack and runs on two AA batteries -- stays with the patient to ensure a comfortable recovery at home.
Bregman is pioneering this new pain-control technique for podiatry surgery in Massachusetts because it brings a variety of medical benefits, he said. Unlike the sledgehammer of general anesthesia, this new technique delivers a local anesthetic precisely to targeted, limb-specific nerves, providing profound pain relief by blocking signals to the brain but leaving the patient fully conscious.
Because general anesthesia suppresses activity in the entire central nervous system, a patient's vital signs must be constantly monitored during surgery. Then, hours after surgery when general anesthesia wears off, the patient begins taking pain medication which may include morphine or other addictive drugs. The analgesic effect of a narcotic pill peaks and gradually disappears so pain comes and goes. Narcotics may also cause nausea, vomiting, constipation and sedation. ...
Very poorly written article. I sent the editor a letter. Here is a copy:
I would like to comment on your above entitled article:
Podiatrists in the States have been perfecting and performing foot surgeries with PCIP (pain control infusions pumps) for years. Most podiatric surgery performed in the states is not under "the sledgehammer" of a general anesthesic, but local regional blocks, that can be sustained using PCIP's. The inference that people undergo general anesthesia for podiatric surgeon is very much 'out-dated' and misleading to the public. Your article infers that most podiatric surgeons are performing surgery under general anesthesia, which , of course is not true for about 99% of all outpatient , podiatric surgery.
Also, by infering that Dr. Bregman is "pioneering" this technique is misleading. Many podiatric surgeons have 'pioneered' this technique for pain control for many years. There are also other pumps that can sustain anesthesia for 'days' rather than just hours as you describe in your article.
Also, the following statement:
The greatest benefit of the new pain pumps and the nerve-block surgical technique is that the patient is apt to stay pain-free and to move around more quickly after surgery," Bregman said. "The more active a patient is, the better prepared they'll be for rehab and the more quickly they'll heal."
This is just a misleading statement. In fact, most surgeons who perform foot surgery do not want people to 'move around more quickly after surgery". This will cause risk of infection , risk of fixation failure and poor results by walking all over their respective foot surgery. The statement that "Bregman said. "The more active a patient is, the better prepared they'll be for rehab and the more quickly they'll heal." This is just plain false and misleading.
The statement following statement in the article that, "Many of Bregman's patients suffer from nerve disease of the lower extremities caused by diabetes, and Bregman performs more lower extremity surgeries on this type of patient than any other physician in Massachusetts" is a statement made without fact. Any podiatric surgeon knows that most diabetic patients don't really require regional blocks, let alone a pain pump for pain control, due to their neuropathy. I have performed a number of amputations on diabetic patients without any local anesthetic at all in diabetic patients. So, this seems to me, a poor way to discuss the use of a pain pump?
This article seems to me nothing more than an advertisement and poorly written.
Al Kline DPM
Last edited by Al Kline DPM : 12th April 2005 at 03:40 PM.
Podiatrist's Patients Remain Awake During Surgery, Yet Stay Pain-Free with High-Tech
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