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Epidural Pain Control Offered At Danbury Hospital Yields Dramatic Post-Operative Results

Monday, January 05, 2009 - Danbury, CT

A former Sea Bees/Marine who doesn’t believe in taking it easy, Larry Miguel even surprised himself when he took a stroll down the hall shortly after undergoing seven hours of major surgery at Danbury Hospital to remove a pancreatic tumor.

“I thought I was superman,” said the Danbury resident, who felt no pain despite the 22-inch incision across his abdomen. “I’m amazed I was able to function so well after having such extensive surgery. I never felt nausea or sleepy. I had no pain whatsoever from beginning to end.”

Miguel may have felt like an action hero. But the real source of his smooth post-operative recovery was an innovative pain management technique that uses an epidural catheter to deliver medication directly to the operative site. For some patients, controlling pain with an epidural catheter can lead to shorter hospital stays, quicker recoveries and fewer anesthesia- or narcotic-related problems after surgery.

“Patients with epidural catheters experience better post-operative results even if they have undergone major surgeries because they are free of pain and discomfort. They are able to rest comfortably and breathe more deeply. And because the anesthetic is localized, patients still have control of their motor abilities, which allows them to get out of bed and walk around sooner. All of these factors contribute to the healing process,” said Martin Serrins, MD, Chairman of the Department of Anesthesiology at Danbury Hospital.

“Low-dose, local anesthetics delivered through an epidural catheter are also safer and more effective than intravenous and oral narcotics,” added Serrins. “Patients avoid the side effects often associated with high-dose narcotics, such as sleepiness, grogginess, respiratory depression, constipation and a host of other issues. They just feel better overall with an epidural catheter.”

The epidural catheter is among the many advanced pain management options available at Danbury Hospital, a regional medical facility and university teaching hospital. The hospital has a specialized pain management team of physicians and nurses with the expertise to administer a comprehensive range of procedures to control pain effectively.

At Danbury Hospital, epidural catheters are used with all major abdominal and chest surgeries and in some bilateral hip and knee replacement procedures. In Miguel’s case, Pierre Saldinger, MD, Chairman of the Department of Surgery at Danbury Hospital, performed major surgery to remove a tumor of the pancreas wrapped around major blood vessels. The surgery required a major abdominal incision from side to side. “It looked like a shark took a big bite out of me,” said Miguel.

Here’s how pain management with an epidural catheter works. Before surgery, physicians implant a catheter into the “epidural space” around the spinal cord in the back. This catheter delivers pain medication to the operative site during surgery and throughout the post-operative recovery period, as necessary. “With an epidural, small amounts of pain medicine may be given continuously or only as needed,” said Serrins. “The medicine works faster than an injection.”

In the operating room, physicians continuously infuse local anesthetics through the catheter to numb the area undergoing surgery. “Patients with an epidural catheter require less overall anesthesia to keep them asleep during surgery because they are getting a local anesthetic to numb the operative site,” explained Serrins.

After surgery, the same catheter is connected to a computerized pump that will continue to infuse a local anesthetic to the surgical site while the patient recovers in the hospital. “We can keep the medicine running through the catheter for four or five days after surgery, as long as the patient needs it for comfort,” he said. The pain management team can supplement the local anesthetic with intravenous or oral pain medication, if necessary.

The epidural catheter was so effective that Miguel was out of bed just two hours after surgery despite having 88 staples across his abdomen. “It looked like I had a big zipper,” he joked. His wife insisted he stay in bed, but Miguel thought otherwise. “I needed to make sure I was all right,” he said. “My wife was shocked, to say the least, to see me walking around.”

These days, Miguel is back to work as a unit enforcement officer with the Unified Neighborhood Inspection Team for the city of Danbury. He’s living life to the fullest after undergoing radiation and chemotherapy as a preventive measure to keep the cancer at bay. “This is my opportunity to have a second shot at life,” he said. “I’m indebted to Dr. Saldinger and the other doctors and nurses at Danbury Hospital. They’re the best.”

About Danbury Hospital

Danbury Hospital is a 371-bed regional medical center and university teaching hospital associated with New York Medical College, the Yale University School of Medicine, the Connecticut School of Medicine and Columbia University Medical Center. It provides centers of excellence in cardiovascular services, cancer, weight-loss surgery, orthopedics, digestive disorders and radiology, with specialized programs for sleep disorders and asthma management. Medical staff members are board certified in their specialties.

Danbury Hospital is ranked in the top 5 percent of hospitals in the country for overall clinical performance by HealthGrades®, an independent health care ratings organization. It is the only hospital in Connecticut ranked among the top 5 percent of hospitals nationwide for overall clinical performance four years in a row.

For more information, visit our website at http://www.danburyhospital.org.




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