Advances are easing surgical pain

PITTSBURGH — All Deborah Keibler knew about hip replacement surgery was the long scar she had seen down the side of her grandmother's body. But when her doctor said the traditionally painful procedure could cure the limp in her right leg, the 49-year-old knew she didn't have a choice.

To her surprise, Keibler was able to leave the hospital the day of her operation and had so little pain she didn't even need painkillers.

Her hip was replaced through "keyhole" surgery — with miniature instruments through tiny incisions — and she was given a regional nerve block in her back instead of general anesthesia.

"For the vast majority of patients undergoing surgery, experiencing postoperative pain is not a must," said Dr. Jacques Chelly of the anesthesiology department with the University of Pittsburgh School of Medicine.

In fact, some experts say pain-free surgery is not so far off.

Doctors say patients timid about having surgeries for fear of pain shouldn't put it off: A new focus on patient comfort and advances in pain management are making many procedures nearly pain-free.

Interest in controlling postoperative pain has exploded in the past five years, said Dr. Barry Cole, director of education for the American Academy of Pain Management, a 6,000-member organization that teaches pain management techniques.

"What we've really come to begin to understand is, you could get conceivably close to pain-free surgery, without necessarily causing the patient any more surgical risk," Cole said.

Anesthesia has been a great tool to keep a patient asleep, immobile and out of pain during complicated surgeries. But once someone wakes up, anesthesia does little to curb the pain caused by cutting into the body, he said.

Charlene Hill, a spokeswoman for the Joint Commission for the Accreditation of Healthcare Organizations, said treating pain helps allay patients' fears about surgery, means less time for recovery and cuts health care costs. In 2001, the hospital accreditation agency adopted standards saying every patient should have the right to have pain assessed and treated.