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Nerve Block Study on Breast Cancer Patients Showing Minimal Post-Surgery Pain

October 27, 2021

Imagine waking up from a major surgery to find that you have very little pain, manageable with low-dose narcotics or even simply Tylenol.

For patients undergoing the extensive DIEP flap breast surgery at St. Vincent’s Medical Center in Bridgeport, this is now a reality thanks to nerve blocks.

Hartford HealthCare’s Jocelyn Maminta recently spoke with anesthesiologist Dr. Emily Harmon about a new study being conducted with breast cancer patients.

“We’ve been doing nerve blocks for all types of different surgeries, but we’ve really tried to apply it to breast surgery and reconstructive surgery,” said Dr. Harmon. “For those patients this reduces the overall amount of pain medicine that they need and hopefully improves their recovery process.”

An ultrasound machine is used to locate the nerves that supply sensation to the surgical area and a numbing medicine is then injected around those nerves.

“Right now, we are doing a study that’s focusing on a surgery called DIEP flap reconstructive surgery,” said Dr. Harmon. “It stands for deep inferior epigastric perforators and it uses the patient’s own tissue to recreate the breast tissue.”

The surgery, which can take seven to eight hours, takes excess tissue from the abdomen to reconstruct a breast after a mastectomy.

“It’s quite a large procedure, as you can imagine, spanning both the chest wall and the abdomen,” said Dr. Harmon. “We use a combination of different nerve blocks to target the nerves that supply the area where the surgery is to dull the pain and reduce the amount of pain medicine that these patients need.”

The nerve block technique has drastically reduced the amount of narcotic pain medication given to patients following the procedure.

“There are several patients that haven’t required any narcotics afterwards, and most of them received very little,” said Dr. Harmon.

Besides lowering the amount of pain medication needed and speeding up the recovery process, it also cuts out the side effects of opiate pain medications such as drowsiness, constipation, itching, delirium and dependency.

“Hopefully, this will be another way that we can reduce the overall amount of narcotic pain medication that’s used in a hospital setting that can have negative impacts on patients who start to develop dependency and addiction to them,” she said. “If we don’t introduce the medication to them or introduce very little amounts, the risk of them developing those dependency issues later on is greatly decreased.”

The study at St. Vincent’s has been accepted for presentation at the PostGraduate Assembly in Anesthesia to be held in December in New York City.

“I think that this will at some point be the standard of care for patients undergoing this breast reconstructive surgery that historically has been very painful and required very high doses of pain medicine,” said Dr. Harmon. “Now it’s one of our lowest pain medication requiring procedures because of the nerve blocks and multimodal anesthetics.”