Pain Block

NEW PAIN MANAGEMENT IN

Dr. Amanda Ellington

Spread of ESP injection

Dr. Kyle Nester

A global pandemic, the strongest hurricane to every hit Louisiana and a follow-up hurricane two weeks later are all things JoAnn Johnson never would have imagined she would have to face, much less during a battle with breast cancer.

Johnson had a mammogram in July and discovered she had breast cancer. Her doctors put together a plan and the first step was a double mastectomy, but then Hurricane Laura set her sights on Southwest Louisiana.

“It was a crazy time,” Johnson recalls. “I evacuated to Oklahoma and was just really in a holding pattern with all the damage and power outages that had happened back home.” She was able to finally have her surgery at the end of September performed by Memorial Medical Group Breast Surgeon Amanda Ellington, MD. As with most surgeries postoperative pain after mastectomy may persist in up to 60 percent of patients. Efforts to reduce postoperative pain and inflammation include a multimodal approach which aims to improve both short and long term pain. This multimodal approach includes administration of anti-inflammatory and narcotic pain medications in addition to more selective pain relief strategies including interventional anesthesia techniques.

“In the age of the opioid epidemic crisis, our aim is to minimize and perhaps even eliminate the need for opioid medications while still providing excellent pain control and, in some instances, complete

BREAST CANCER SURGERY

pain relief,” Ellington says. “A mastectomy brings with it all types of emotions and concerns from patients, and we want to make this procedure as stress free as possible and reducing pain associated with the surgery plays a big role.”

That is why Dr. Ellington has teamed up with Memorial Hospital anesthesiologists with a new pain relief procedure to help patients recover faster post-surgery. In the past, epidurals and other more selective nerve blocks have been utilized to help combat postoperative pain in the upper abdominal and chest areas. More recently, a novel procedure called the Erector Spinae Plane Block (ESP Block for short) has been prescribed and may be performed by a physician anesthesiologist prior to procedures.

“In our practice, we have been performing the ESP block prior to mastectomies with excellent postoperative pain relief and patient satisfaction,” says Memorial Medical Group Anesthesiologist Kyle Nester, MD. “The ESP block is found to come with less risks than an epidural, requires less pain medication later on and allows most patients to go home the next day.”

The ESP block is a procedure where an ultrasound guided regional anesthetic is injected into a specific location in the muscles of the back. This leads to a good 48-72 hours of pain relief immediately following the surgery during a time when pain can be at its worst.

“I think it’s great when physicians from different specialties can collaborate to improve the patient experience,” Dr. Ellington says.

Johnson, a retired nurse, found the ESP block to work as advertised. She has had experience with similar never blocks having had one last year when she underwent shoulder surgery.

“I didn’t have to take very much pain medicine as the pain was controlled and manageable. I really don’t care for opioids and how they make me feel,” Johnson says. “This was a nice alternative that helped me recover quicker and at the right time as Hurricane Delta would soon hit our area.”

For more information about the ESP Block or the Memorial Breast Health Center, go to www.lcmh.com/breasthealth

Current Breast Cancer Statistics:

Breast cancer is the most common cancer among women in the United States, accounting for nearly 30% of all newly diagnosed cases.

Every 2 minutes, a new case of breast cancer is diagnosed in the U.S.

In 2020, it is expected that more than 276,000 cases of breast cancer will be diagnosed.

An estimated 42,000 women will die of breast cancer in 2020.

There are more than 6 million breast cancer survivors worldwide, 3.8 million of those are in the U.S.

Approximately 5-10% of breast cancers can be linked to known genetic mutations inherited from one’s mother or father.

Improvements in early detection and screening have led to a 40% decline in breast cancer deaths in the U.S.