From episode 140 of the Surgery podcast. With Dr. Toby Trimble.
This one is less of a pearl and more of a lightbulb moment. In this discussion about local nerve blocks anaesthetist Dr Toby Trimble explained why local blocks are so important:
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If we take the definition of ‘analgesia’ as a reduction in pain perception, then our opioids are not actually analgesics. They don’t stop pain propagation - they just make you care less about the pain!
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Local anaesthetics, on the other hand, actually block the propagation of the pain signal from the site of injury to the dorsal horn and the brain.
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That’s a good thing! Dr Toby uses the metaphor of forest path: the more it’s used the more well-worn it becomes, the easier it is to travel along that path. Pain is the same, and local blocks stop (or at least delay) the pain signal from starting a new track in the forest that is the nervous system.
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This means fewer ‘stop worrying about the pain’ meds during and after surgery.
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