Anesthesia with Fewer Opioids Means Patients Suffer Less Nausea and Some Experience Better Pain Relief

The ComfortSafe Pyramid™ is a checklist for treating pain when a patient is under anesthesia. It is a hierarchy and, like going up the steps of a pyramid, pain is first treated using the safest methods with the fewest side effects. Often, we don’t have to go to the higher levels at which nausea, vomiting, and prolonged sedation are so common.

November 17, 2014

Chronic Pain Sufferers Already Taking Narcotics for Pain Can Benefit from New Anesthesia Technique

(November 17, 2014- Washington, D.C.) When 58-year-old Angi English of Austin, Texas was in Washington, D.C. as a student of the Naval Postgraduate School this past summer, it was during a walking tour of the White House that the pain in her foot became so excruciating she asked to be taken to the closest emergency department. What she thought was a spider bite turned out to be a serious and stubborn infection that wouldn’t heal. She had a raging superbug infection (Methicillin-resistant Staphylococcus aureus or MRSA) and needed immediate surgery to save her foot.MGUH-Angi-English-Anesthesia

“There I was, far away from home, facing surgery, which to me always meant intense nausea and vomiting from the anesthesia I was routinely given,” said English. ”It was always an uphill battle for me to come out of the anesthesia and sometimes I had to stay longer in the hospital just to recover from the anesthesia medications.”

But in the hours before her operation, Joseph Myers, MD, anesthesiologist at MedStar Georgetown University Hospital counseled English about a new technique that involves fewer opioids for pain and instead relies upon narcotic alternatives which are associated with less nausea. Dr. Myers developed the ComfortSafe Pyramid™ as the foundation of the ComfortSafe Anesthetic technique. “The technique focuses on the use of narcotic alternative medications, several of which are newly available. It allows us to relieve pain and avoid narcotic side effects including nausea, vomiting, respiratory depression, hypotension, constipation, addiction and prolonged confusion,” said Dr. Myers.MGUH-Anesthesia-Foot-1

“When I woke up after my surgery I was clear headed and alert. I remembered the conversations I’d had with my doctors and nurses, I ate crackers and apple juice right away and had no pain,” said English. “A little later I went up to my room and I ate Greek yogurt with raspberries and honey and drank coffee and never felt one ounce, not one iota of nausea. It was like night and day compared to my previous experiences with anesthesia.”

The ComfortSafe Pyramid™ is a checklist for treating pain when a patient is under anesthesia. It is a hierarchy and, like going up the steps of a pyramid, pain is first treated using the safest methods with the fewest side effects. Often, we don’t have to go to the higher levels at which nausea, vomiting, and prolonged sedation are so common.

“This reduced use of opioids or narcotics in anesthesia is a trend that is being adopted by practitioners nationally and in our department, “ said Russell Wall, MD, chief of Anesthesia at MedStar Georgetown. “We also see this as a very beneficial technique in the growing number of patients with chronic low back, hip or knee pain who present to us on large doses of opioids.”

“In patients who are opioid tolerant we emphasize non-narcotic pain medications to avoid worsening the patient’s dependence on opioids,” said Dr. Myers. “The ComfortSafe Pyramid™ directs these choices for treating pain allowing us to reduce and sometimes completely avoid opioid narcotics, their side effects and addictive potential. Narcotics are still readily available, if needed, since patient comfort remains the priority.”

“I never thought I’d be delightfully happy with the anesthesia portion of any surgical experience,” said English. “But that’s exactly what happened. Because of my successful and uncomplicated surgery I was able to finish my class in Washington, D.C. and I’ll be graduating with my master’s degree this December. If I ever have to have surgery again here in Texas I plan on asking about and educating the medical personnel here about the ComfortSafe Technique.”

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