Almost anyone who has had narcotic pain medications after surgery knows that feeling of grogginess and disorientation that morphine or Demerol can cause. While pain is relieved, the drugs act systemically, sometimes causing nausea and constipation, even respiratory problems.

Now a new choice in pain control is available through some Fort Wayne doctors. The ON-Q Pain Buster system relieves pain at the surgical site, without complications caused by days of narcotic drug usage.

“It works differently, blocking totally the pain fibers from firing,” said Dr. Ron Baker with Northeast OB-GYN. He and colleague Dr. Geoffrey Cly have been using the ON-Q system for nearly six months.

Injected or oral narcotics do not target the actual cause of pain. They dull the sensation, and the brain interprets the pain differently. A drug such as ibuprofen temporarily disrupts the pain signals that reach the brain. As long as the drug is active in the system, relief is felt.

The ON-Q system consists of a small balloon pump that holds local anesthetic, usually Marcaine, a longer-acting version of Novocaine. A thin antimicrobial catheter carries the medicine to the surgical site, where the surgeon has placed the end of the catheter before closing the incision. Through tiny holes, a constant flow of medicine spreads through the area. The catheter is taped in place. The patient goes home with the bag in a small purse that can be clipped to a shirt or worn with a shoulder strap.

No buttons need to be pressed. The natural pressure of the bag administers the drug at the right amount. After two to three days, the bag deflates. The patient then gently pulls out the catheter and discards the system.

Baker has had only one woman who was squeamish about removing the catheter. Over the phone he talked her through the simple, painless procedure.

Whitley Hale, 27, of Woodburn, is enjoying her 7-week-old son, Jackson, delivered by Caesarean section. She had the ON-Q system after Jackson's birth, but had intravenous and oral narcotics after the Caesarean delivery of her daughter, Addison, now 2 1/2 . With Addison, she remembers feeling groggy and dizzy but said, “This time it went really, really well.”

After Jackson's birth, nurses kept asking her to use her patient-controlled analgesic (PCA) pump containing narcotic medicine, she said. “They told me I needed to use it to stay on top of the pain, but I didn't have any. They said I never used (the PCA) during the night. I filled all the (oral pain) prescriptions the doctor gave me, and I didn't even take one after I got home.

“My sister-in-law is due at the end of May. I told her if she has a C-section, she should have the ON-Q.”

General anesthesia is still given during surgery, but Cly said he has found by using Marcaine periodically during the operation, injecting it into deeper tissues, then putting in the ON-Q system, women are up and around sooner, pain-free.

“Most are telling me they are not needing narcotic pain medicine at all,” Cly said.

Today's normal stay for a laparoscopic hysterectomy is 23 hours, but Cly has many patients now who want to go home earlier, some in as few as three hours, although he encourages them to stay for as long as their insurance allows.

“I don't demand they go home,” he said, “but it is dramatic how much better they feel with the ON-Q rather than narcotic pain relief.” The only downside of ON-Q, he said, is that patients may feel so good they do too much when they get home. He tells women to put sticky notes around the house as a “slow down” reminder.

Cly and Baker, who receive no remuneration from I-Flow, the makers of ON-Q, are using ON-Q for a variety of gynecological surgeries, as are a few other Fort Wayne OB-GYNS. Some orthopedists and plastic surgeons are also using the ON-Q system which, at about $375, equals about one day's PCA usage.

“Historically, we've always thought about doing the surgery and then about dealing with the pain afterward. Now we're finding out that using a combination of things is best,” Cly said.

As for the gynecological procedures, he said ON-Q “is allowing women to get back to life faster.”