Many Patients Don’t Need Opioids After Surgery


MONDAY, June three, 2019 (HealthDay News) — The opioid epidemic has been fueled partly by the overprescribing of painkillers. But a brand new research finds that as much as half of sufferers could not really want the addictive drugs following a surgical procedure.

The discovering may very well be a game-changer for post-op care, mentioned lead researcher Dr. Michael Englesbe.

“We think a fundamental root cause of the opioid epidemic is opioid-naive patients getting exposed to opioids and then really struggling to stop taking them post-operatively,” mentioned Englesbe, a professor of surgical procedure on the University of Michigan in Ann Arbor.

If sufferers discover that they cannot wean themselves off the opioid, that may rapidly escalate to “chronic opioid use, abuse, addiction and overdose,” he mentioned in a college information launch.

So, since 2010, medical doctors have been urged to prescribe fewer narcotic painkillers. According to the researchers, major care medical doctors have heeded the decision, however prescriptions by surgeons truly rose 18% between 2010 and 2016.

But do surgical sufferers want all these opioids?

To discover out, Englesbe and colleagues performed a pilot research of ache administration after six surgical procedures.

They discovered that greater than half of sufferers merely did not want post-op opioids to handle their ache.

A complete of 190 sufferers, all new to opioids, have been included within the research. They underwent one in all six sorts of operations: gallbladder, thyroid, hernia, prostate, sinus or weight-loss surgical procedure.

To handle their ache, sufferers got prescriptions for acetaminophen (one model title is Tylenol) and ibuprofen, plus a small “rescue” prescription of the opioid oxycodone (one model title is OxyContin) if wanted.

Patients have been instructed to take acetaminophen or ibuprofen each six hours and to stagger these medication by three hours.

In the week following surgical procedure, sufferers have been requested to charge their ache on a scale of zero to three, with zero being no ache and three extreme ache.

Between 30 and 90 days after surgical procedure, sufferers have been additionally requested what number of opioids they took.

The researchers discovered that greater than half (52%) of sufferers did not use any opioids in any respect. The 48% who used opioids took a mean of simply 4 drugs. The common ache rating for all sufferers was 1, and for many who took opioids it was 2.

Most sufferers additionally mentioned they have been “extremely satisfied” with their therapy.

Englesbe pressured that “simply not giving opioids will not be the reply — we have now to offer the very best ache care. From the start, everybody was on the identical web page with speaking to sufferers about their ache and letting them know that operations damage.

“Our purpose is to have half the operations performed with out sufferers needing opioids and nonetheless getting glorious ache care, Englesbe mentioned. “There are alternatives to opioids for surgical pain that work well and we should be using them more.”

One ache specialist who wasn’t concerned within the research mentioned the findings have been “remarkable.”

“It challenges prevailing beliefs of the very role opioids need to play in effective pain management,” mentioned Dr. Harshal Kirane. He directs dependancy providers at Staten Island University Hospital in New York City.

“Judicious opioid management is increasingly a shared responsibility between prescribers and patients,” Kirane mentioned. He mentioned there are “useful options to alleviate pain” that stretch past opioids, “ranging from medications to non-pharmacologic alternatives.”

The report was revealed on-line May 31 within the Journal of the American College of Surgeons.

More info

The American Society of Anesthesiologists affords extra info on managing post-surgical ache.

SOURCES: Harshal Kirane, M.D., director, dependancy providers, Staten Island University Hospital, New York City; University of Michigan, Ann Arbor, information launch, May 31, 2019



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