Controlling pain after surgery doesn’t have to mean opioids

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Surgeons often try to balance the need to control their patients’ post-surgery pain with the risk that a routine operation could become the gateway to long-term opioid use or addiction.

In a new study, researchers found that reducing pain after surgery doesn’t have to mean opioids.

The research was conducted by a team at Michigan Medicine.

In the study, the team tested 620 patients who had surgery in hospitals across Michigan, had their painkiller use tracked, and took surveys within one to three months after their operations.

Half of the patients received pre-surgery counseling that emphasized non-opioid pain treatment as their first option.

Some patients in this group received small, “just in case” prescriptions, but a third of them didn’t receive any opioid prescription at all after surgery.

The other patients received standard care – meaning they got the usual amount of opioids given after these operations.

Not only did every patient in that group get an opioid prescription, those prescriptions tended to be larger than those in the other group.

And most patients didn’t take them all – leaving extra pills that can pose a hazard to the patient or others in their household if taken inappropriately or diverted to illicit use.

The patients in the two groups had the same operations – gallbladder removal, full or partial thyroid removal or hernia repair.

But despite the difference in painkiller use, the patients in both groups were equally satisfied with their care and reported similar quality of life when contacted later.

And those in the opioid-sparing group actually reported experiencing less pain overall.

The team says reducing opioids prescriptions does not only reduce the risk of opioids addiction but also strongly decrease the risk of opioid diversion into communities.

But that idea always raises the concern that patients will have uncontrolled pain and feel miserable.

This study suggests that’s not the case – patients who get small opioid prescriptions, or even no prescription, are just as satisfied with their recovery after surgery.

One author of the study is Maia Anderson, M.D., a resident in the U-M Department of Surgery.

The study is published in JAMA Surgery.

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