Scientists find how to reduce post-surgical pain without opioids

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In a new study from the University of Miami, researchers found that patients don’t necessarily need opioids for pain relief following robotic prostatectomies.

They found that strategic use of local anesthetic and non-steroidal anti-inflammatory drugs (NSAIDs) plus acetaminophen can effectively control post-surgical pain without narcotics.

In the study, the team examined 157 robotic prostatectomy patients at the Miami Veterans Affairs Medical Center, with around half receiving opioids.

The local anesthesia is called bupivacaine, which is similar to what a dentist uses. It was supplemented with IV acetaminophen and ketorolac, a prescription NSAID.

Five patients in the narcotic-free group ultimately needed opioids. The opioid-free group reported much less pain and experienced fewer post-operative complications.

Many people did so well in the hospital – being able to eat sooner, get out of bed and move around more easily and not have much pain.

Emergency room visits and readmissions were about the same in both groups. Continued monitoring showed no increase in opioid prescriptions after patients returned home.

The team says it is possible to eliminate opioids and have better pain control in a population that, due to anxiety, post-traumatic stress disorder issues and previous exposure to opioids, would be considered vulnerable and have a lower threshold for pain.

Not surprisingly, this approach evoked some skepticism from both patients and providers. One patient was only convinced to try it when the team assured him that if he needed opioids, he would receive them.

When the researchers visited the patient soon after surgery, he said, “This seems like a long time to wait. When is my surgery?”

The team says this approach could help alleviate a major concern among surgeons, who need to manage patients’ pain but must also guard against potential addiction. The authors believe this method can help rectify both issues.

If you care about opioids and pain, please read studies about a new way to help people with chronic pain, depression and findings of chronic opioid use may increase risk of this mental problem.

For more information about pain management, please see recent studies about this anti-itch drug may help prevent opioid overuse and results showing that a new way to treat chronic neuropathic pain.

The study is published in the Journal of Robotic Surgery. One author of the study is Leslie Deane, M.D.

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