As director of interventional pain management and the Interventional Spine Center at Elliot Hospital, Dr. Brian Klagges performs a variety of procedures to relieve patients’ pain. In doing so, Brian Klagges, MD, draws on an in-depth knowledge of such advanced techniques as neuromodulation.
A treatment for intractable pain since the 1960s, neuromodulation uses implanted devices to manipulate nervous system activity. Many such devices are known as neurostimulators, which means that they work by altering the electrical impulses that govern the nervous system. One common such technique is spinal cord stimulation, which requires a surgeon to place an electrode in the body next to the spinal cord. This electrode generates a gentle current that blocks pain signals along the spinal cod.
Physicians may also place such electrodes along the sacral nerve, which is located in the pelvic area and responsible for many forms of pelvic pain. Intraspinal nerve root stimulation, which involves an electrode placed near the nerve root of the spine, addresses pain in the pelvic region as well as in the abdominal area. A final type, peripheral nerve stimulation, may offer relief for more distal processes.
There are also a number of neuromodulation processes that involve targeted medication delivery rather than nerve stimulation. These require the implantation of drug pumps rather than electrodes and allow for the deliver of significantly smaller doses. Such dosing may also reduce the likelihood of side effects, while potentially leading to more effective pain relief.
Anesthesiologist and pain interventionalist Dr. Brian Klagges, MD, currently administers treatment to patients at Elliot Hospital in Manchester, New Hampshire. One of the procedures that pain interventionalists like Dr. Brian Klagges are licensed to perform is the epidural, which is commonly used to aid women in the process of childbirth.
An epidural is a type of regional anesthesia that temporarily blocks the activation of pain receptors within a woman’s lower spine. Though epidurals administered during birth are designed to diminish the pain associated with labor, they are not designed to completely quench feeling.
In order to administer an epidural, an anesthesiologist locates the spinal membrane and inserts a needle into the back of the woman in labor. This needle is larger than standard needles in order to allow a catheter to pass through it. Once the catheter is inserted, it is taped in place and the needle is withdrawn. Leaving the catheter in the back allows the anesthesiologist to administer additional pain medicine as needed during the delivery.