Managing pain for a speedy recovery

NEW DELHI: Sixty-year-old Satish Nagpal dreaded the pain more than the surgery for his ulcers. He was in for a pleasant surprise though. Doctors at Sir Ganga Ram Hospital's anaesthesiology department inserted an epidural inside his body that took care of the post-operative pain.
Thanks to the patient control analgesia (PCA) pump, not only did Nagpal recover fast, he was also able to self-administer painkiller doses through a switch.Interventional pain management is now being seen as a route to speedier recovery.
Doctors and patients alike are increasingly waking up to the benefits of pain relief and management in the city. According to Dr Pradeep Jain, senior consultant anaethesiologist, Sir Ganga Ram Hospital: "Pain today is as good as any of the vital signs we look for in a patient, like BP and pulse.
Interventional pain management takes away the stress of the ailment from the patient and his family." The procedure has especially worked wonders with cancer patients. Said Sarita Vasudev, suffering from cancer of the bile duct: "My pain has gone down by as much as 80 per cent after being given systematic pain relief.
I can now eat properly and even move a little." Vasudev was fitted with an intrathecal pump. In this, doctors are able to inject painkillers continously into the spinal cord with the help of a pump implanted inside the patient's body.
"A radio frequency coagulation machine is used for bringing relief. This machine coagulates the nerves transmitting pain. Soon after, the patient stops feeling any painful sensation," explained Dr Jain. In fact, techniques are also being used to pave way for painless delivery.
"In several cases, we administer epidural injections while the patient is in labour. This however, is done only at the obstetrician's instructions, and in a phased manner, as the labour progresses.
In other countries, epidural injections are used quite commonly for child births unlike here," said Dr A K Sethi, head of anaesthesia, Guru Tegh Bahadur Hospital. But cutting down on the pain comes at a cost. "Intrathecal pump is very expensive and so is less used.
Its range starts from Rs 2 lakh," said Dr Sanjiv Aneja, senior consultant, anaesthesia, Apollo Hospital. Agreed Dr Sethi: "They could be a huge help, but the cost is a deterrent. So, we have to do without these machines."
Thus, doctors mostly make use of methods like nerve-blocking, where the cycle of pain is first broken by applying a local anaesthesia on thepain-transmitting nerve and then permanently, by using chemical agents or epidural injections.