Doctor helps palliative patients manage pain without narcotics

Patients are taught to self-administer local anesthetics as needed and can be present with their loved ones

By Kathryn Perrier

It’s really tough for anyone who is supporting their loved one through their final days of life.  Caregivers don’t always know what to expect and most don’t realize that the patient could need pain medication that could render them unable to communicate.  But at Southlake Regional Health Centre (Southlake), Dr. Alim Punja is providing compassionate care to palliative patients that allows them to manage their pain without narcotics.

When patients receive a terminal cancer diagnosis, the question of how much pain they will experience is always top of mind.  Southlake’s Palliative Care team and Dr. Punja are taking chronic pain management to the next level to allow patients to live their remaining days with less pain and less sedation during those last meaningful moments.

“Uncontrolled pain is something that all palliative patients and their families worry about in their final stages of life and knowing that there may be an alternative solution gives patients and their families hope,” says Dr. Punja, on ways he is always looking to do things better for his patients.

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Dr. Punja is an anesthesiologist at Southlake.  He has extensive expertise in treating cancer-related pain for our palliative patient population.  Together with the Palliative care doctors, they have found a way to help our palliative cancer-care patients manage their pain while decreasing or avoiding the use of narcotics.

Most recently, Dr. Punja treated a patient who was using very high doses of narcotics for pain that made her essentially uncommunicative with her family.  Dr Punja arranged for her to have a permanent IV line and taught her partner to administer small doses of local anesthetic at home, as needed.

In the final days of her life, this patient was essentially off all narcotics and could fully communicate with her family.  Families and patients say Dr. Punja’s work, to keep his patients comfortable and able to communicate in their last days of life, means the world to them and to their loved ones. They are also grateful to Dr. Punja for giving them time together. Without this alternative treatment, they would have never been able to say everything they needed to say during those last days and moments.

This is the first time a Southlake patient has received this level of care, where the patient or family member is taught how to administer small doses of local anesthetic as needed instead of using narcotics.

Arden Krystal, president and CEO of Southlake Regional Health Centre says, “I am thrilled to see this dedication to our patients, and to know that this patient and her family had added quality time together is incredible.  Thank you to Dr. Punja and his team for this great work in serving this patient and her family with purpose.”

Dr. Punja will continue to support his patients in the same manner in order to keep them comfortable, offering them the opportunity to live their last days with less pain and to be able to communicate with their loved ones.

Dr. Punja is as an anesthesiologist and interventional chronic pain physician with the department of anesthesiology at Southlake Regional Health Centre. After completing his medical training at the University of Calgary, Dr. Punja then completed postgraduate training in anesthesiology at the University of Ottawa and a clinical fellowship in interventional chronic pain management at the University of Toronto.

For more information about the science behind this approach and how lidocaine infusion can work as an effective approach for management of chronic pain please click here.