Understanding Occipital Nerve Stimulation

Board certified in anesthesia with a subspecialty in pain medicine, Dr. Brian Klagges has helped numerous patients achieve relief from chronic pain. As a staff physician at Eliot Hospital in Manchester, New Hampshire, where he has practiced since 2007, Dr. Brian Klagges performs a wide range of pain management treatments, including occipital nerve stimulation.

Used to treat severe headache disorders and craniofacial pain, occipital nerve stimulation involves electrically stimulating nerves in the occipital lobe of the brain at the back of the skull to eliminate pain in the head. To do so, a physician implants a small pulse generator just under the skin in the abdomen, back, upper buttock, or upper chest. An attached lead is placed under the skin at the base of the skull, where the occipital nerves are located.

This treatment does not work for everyone, and that is why pain medicine specialists perform a trial before implanting the device. In the trial phase, the leads are placed near the occipital nerves, but the pulse generator is kept external to the body. The patient then keeps a pain diary for about a week to determine if a significant improvement in painful symptoms has occurred. If so, the patient can proceed with receiving the permanent implant.

Occipital nerve stimulator implantation is well tolerated by most patients. Complications are rare and may include infection at the surgical site or the need for secondary surgery to adjust the leads. Several studies show that roughly 75 percent of patients report good pain control 10 years or more after implant placement.


Elliot Health System Named Most Wired for Fourth Consecutive Year

An anesthesiologist and pain interventionalist, Dr. Brian Klagges has earned widespread recognition for his patient-focused and groundbreaking work in New Hampshire. Dr. Brian Klagges leverages his expertise in the field of pain management to serve as the director of interventional pain management and the director of the interventional spine center at Elliot Hospital in Manchester.

For the fourth consecutive year, Elliot Health System was featured in Hospitals & Health Networks magazine as one of the nation’s “Most Wired” hospitals. The title “Most Wired” is awarded to health care organizations that utilize technology to provide patients with better care. For example, 81 percent of Most Wired hospitals use bedside bar code technology to appoint medications to the patient, nurse, and order. The majority of most wired healthcare establishments use technology to decrease the occurrence of medical errors and to share critical medical information with other care professionals.

Using data from the annual Health Care’s Most Wired Survey, hospitals are assessed across four operational components to evaluate their use of technology to improve clinical and financial processes. The survey questions explore hospitals’ tech initiatives and strategies for implementing electronic health records.

How Does Nerve Ablation Work?

Dr. Brian Klagges, an accomplished anesthesiologist in New Hampshire, provides interventional care at Amoskeag Anesthesia. Also the director of the Elliot Hospital interventional pain management program, Dr. Brian Klagges offers genicular nerve ablation for patients with severe arthritis in the knee.

By definition, nerve ablation involves the destruction of nerves that are causing a patient to experience chronic pain. To determine whether the procedure is likely to be effective, a surgeon will likely begin by performing a nerve block test. By numbing the target nerves, the surgeon can determine whether permanent ablation would have the desired effect.

Patients who respond positively to the nerve block test may be approved to receive permanent ablation. A surgeon performs the procedure with the patient under a local anesthetic which numbs the area to be treated. With the aid of real-time X-ray technology, the surgeon directs the ablation device under the skin and toward the nerves that have been determined to be the source of the pain. The ablation of a single nerve typically lasts for 60 seconds, and the full procedure is often complete in 20 minutes. Most patients can return to normal activity levels within two days.

An Introduction to Percutaneous Hydrodiscectomy

A skilled pain interventionist and anesthesiologist, Dr. Brian Klagges has served patients at Elliot Hospital in Manchester, New Hampshire, for nearly a decade. Dr. Brian Klagges had the honor of becoming the first medical professional in New Hampshire to perform a percutaneous hydrodiscectomy. A minimally invasive procedure, it involves the use of a high-speed stream of water to remove herniated disc tissue. The procedure relieves the nerve pressure caused by a herniated disc and provides relief from associated back and leg pain.

Practitioners perform the procedure with guidance from a fluoroscope, which provides a live X-ray image of the patient’s spine. This imaging allows doctors to avoid making a large incision. It takes only about 20 to 30 minutes to complete the procedure. Generally, patients need only local anesthetic and can return to their daily lives quickly. Doctors typically perform percutaneous hydrodiscectomy on an outpatient basis.

This procedure involves significantly less pain than traditional treatment options for herniated discs. In addition, it does not cause trauma to back muscles and surrounding tissue.

ANESTHESIOLOGY 2014 to Be Held in New Orleans

Accomplished anesthesiologist Dr. Brian Klagges serves as the director of interventional pain management and the director of the Interventional Spine Center at Elliot Hospital in Manchester, New Hampshire. An involved professional, Dr. Brian Klagges maintains memberships in several medical organizations, including the American Society of Anesthesiologists.

Registration is now open for the American Society of Anesthesiologists’ ANESTHESIOLOGY 2014 annual meeting, which will be held October 11 to 15 at the Ernest N. Morial Convention Center in New Orleans. Attendees at the five-day event will have the opportunity to hear from experts in the field and to earn up to 44 continuing medical education credits through a range of educational sessions covering topics critical to today’s anesthesiologist.

Outside of the educational programming, ANESTHESIOLOGY 2014 will provide attendees a number of networking opportunities, including a welcome reception and the 5th annual Hope For The Warriors 5K Run/Walk, which supports wounded warriors and their families. This year’s event will also feature a connection center, where individuals can meet with other physicians and explore the latest research and technology related to anesthesiology.

ASRA’s Annual Regional Anesthesiology and Acute Pain Medicine Meeting

An accomplished anesthesiologist and pain medicine specialist, Dr. Brian Klagges currently works at Elliot Hospital and Amoskeag Anesthesia, PLLC, in Manchester, New Hampshire. Outside of treating patients, Dr. Brian Klagges works to improve his practice through his membership in organizations such as the American Society of Regional Anesthesia and Pain Medicine (ASRA).

As a component of its education program, ASRA holds a variety of local, state, and national events, including its Annual Regional Anesthesiology and Acute Pain Medicine Meeting. Attracting more than 1,000 individuals each year, the three-day event gives those in attendance the opportunity to enhance their knowledge and skills through a range of educational sessions and hands-on workshops led by experts in the field of anesthesiology and pain medicine.

ASRA’s next Regional Anesthesiology and Acute Pain Medicine Meeting will take place May 14-16, 2015, at Caesars Palace in Las Vegas. In addition to a diverse education program, the meeting will feature several special events to celebrate ASRA’s 40th anniversary. Detailed information for this meeting and other ASRA events may be found at http://www.asra.com/education-upcoming-events.php.

Understanding Local and General Anesthesia

Since 2007 Dr. Brian Klagges has worked as a physician and anesthesiologist at Elliot Hospital in Manchester, NH. In 2006 Dr. Brian Klagges was recognized with the Robelen Award, given to the top graduate resident in Anesthesiology at Tufts University’s Caritas-St. Elizabeth’s Medical Center in Boston, Massachusetts.

General anesthesia can be described as medically-facilitated states of unconsciousness that can be reversed by doctors. Local anesthesia is typically administered via injection in an effort to block sensory nerves in a specific part of the body. For example, during a routine dental procedure, dentists generally do not induce a state of complete unconsciousness but rather locally anesthetize the target oral structures in order to prevent the perception of pain during a procedure.

General anesthesia is a medically induced coma and loss of protective reflexes resulting from the administration of one or more general anesthetic agents. A variety of medications may be administered, with the overall aim of ensuring sleep, amnesia, analgesia, relaxation of skeletal muscles, and loss of control of reflexes of the autonomic nervous system. The optimal combination of these agents for any given patient and procedure is typically selected by an anesthesiologist or another provider such as an anesthesiologist assistant or nurse anesthetists, in consultation with the patient and the medical or dental practitioner performing the operative procedure.