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The Joint Connection: The Evolution of Pain Management

Naixi (Nelson) Li, MD, PhD, chief of Anesthesiology at Lawrence Hospital Center
Naixi (Nelson) Li, MD, PhD, chief of Anesthesiology at Lawrence Hospital Center Photo Credit: Contributed

When patients come to Lawrence for joint replacement surgery, one of their biggest concerns is post-op pain. Taking steps to restrict or eliminate that pain altogether is the focus of a team led by Naixi (Nelson) Li, MD, PhD, chief of Anesthesiology at Lawrence Hospital Center. Dr. Li says his group of highly trained physicians has two primary goals – safety and comfort. “We take an important and active role in evaluating and planning for a patient long before the patient ever has surgery,” states Dr. Li.

Multi-modal pain management allows physicians to be preemptive – controlling pain before it happens. Prior to surgery, the anesthesiologist builds up a patient’s pain tolerance with a variety of methods including anti-inflammatory and non-steroidal pain medications. During surgery or intra-op, Dr. Li says proudly that Lawrence Hospital Center is one of the first community hospitals to provide IV-Acetaminophen (Tylenol) which is much stronger than over-the-counter pills, to patients intravenously. Other options include nerve blocks that take away 80 to 90 percent of the pain when used in shoulder, arm, hand, hip, knee and ankle surgeries. When utilizing nerve blocks, Li says there is less reliance on narcotics to ease the pain. “That’s important because narcotics can cause all kinds of side effects like nausea, dizziness, itching and constipation,” says Li.

With technological advancements and the introduction of new medications, today’s anesthesiologists have a larger arsenal of tools to anesthetize patients with and to control their pain after surgery. Additionally, the Internet and regular specialty meetings give these physicians access to the latest procedural options and medications available. Previously, Li says an anesthesiologist was typically seen as the faceless guy in the room putting the patient to sleep. “The old joke was that we were the gas man. Now, our job has evolved into a more complex and integrated system which improves safety and a patient’s comfort throughout surgery. It also allows us to work even more closely with the surgeon,” adds Li.