Improvements in anesthesia

September 14, 2009 3:36:58 PM PDT
Anesthesia is a necessary part of surgery. It puts patients into a deep sleep state so they don't feel pain and can remain immobile. But it's not without some minor discomforts. Now, some operations can now be done without general anesthesia, such as breast cancer surgery.There is a growing trend toward using what is called "regional nerve block anesthesia." It deadens only a part of the body and recovery from the surgery can be much faster.

Ann Nixon went to New York Presbyterian Hospital to have a lumpectomy for breast cancer. She's had several surgeries, including heart bypass and knee surgery, all done with general anesthesia.

"I get nauseated and it takes me two days to wake up," she said.

But this time, Ann had a different kind of anesthesia -- a regional nerve block. This surgery allowed her to leave the hospital just four hours later with no ill effects from the anesthesia.

"I feel like I never had anesthesia," she said. "I had a cheeseburger and a ginger ale and coffee and now I feel brand new."

Brand new just hours after surgery, at which time the anesthesia was delivered by injections directly into her spine. The nerve block anesthesia will only block nerve signals going directly to her mid chest.

"You avoid the breathing tube placed in your windpipe, also with the nerve block, you often have extended pain control after the surgery, sometimes up to 12 to 24 hours," said Dr. Tiffany Tedore.

Ann didn't have nausea. She also had mild IV sedation, so she slept lightly during the surgery. Within minutes, doctors had removed the malignant tumor and surrounding tissue. Tests determined no lymph nodes in the area had any cancer. But had there been any, doctors could have continued operating without having to stop to administer general anesthesia. If nodes were positive, it would have been different story without the nerve block.

"We would have had to stop to do a full general anesthetic, including intubation, putting in a breathing device in the airway," said Dr. Tedore.

But because she had the nerve block, Ann was home by the afternoon and feeling fine. She's undergoing radiation now and doing well in her cancer therapy. There are several clinic trials going on around the country, assessing the positive benefits of nerve block, including whether it prevents the recurrence of cancer.

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