Doctors devise safer alternative to opioids during, after surgeries (Early acetaminophen erased need for opioids)

Medical Xpress / American Society for Metabolic and Bariatric Surgery & other societies ^ | Apr. 28, 2022 | Denise Mann / Dr. Dominick Gadaleta et al

[ConservativeMind]

There is a big push across all of medicine to find alternatives to opioids due to the nationwide opioid epidemic. Many people first become addicted to these powerful painkillers following surgery.

Instead of opioids, people undergoing weight-loss surgeries at Northwell Health Hospitals in New York receive intravenous acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) before surgery. This is followed by an intravenous infusion of non-opioid anesthetics and a nerve block of the surgical area.

"We essentially turn the nerve endings down or off before surgery with preemptive acetaminophen or NSAIDs," explained Dr. Don Decrosta. "When we get hurt or undergo surgery, the nerve endings in the injured area fire at a much higher rate, but if we blunt or eliminate this stress response with preemptive [pain relief], you get through the early healing days without the need for opioids."

Opioids block pain signals between your brain and body, while the new protocol is more targeted, he said,

People don't get sent home with a prescription for opioids because they don't need them, said Dr. Andrew Bates.

These folks aren't necessarily pain-free in the days following their procedure, and that's a good thing, Bates noted. "They may have some soreness afterward and that's OK because it's a major surgery and pain can give us important information," Bates said. "We never want to completely cover up pain."

In addition to a heightened risk of addiction and overdose, opioids cause many short-term side effects that can hamper recovery, including nausea, itching, fatigue, dizziness and constipation, said Dr. David Pechman. Opioids slow down your intestines so you don't have bowel movements, but "with the new protocol, patients have regular bowel movements and are walking around the afternoon of their surgery."

[ConservativeMind]

Aside from acetaminophen, they also use a nerve block and a non-opioid anesthesia.

[ConservativeMind]

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[Governor Dinwiddie]

So instead of becoming addicted, you will need a liver transplant?

[E. Pluribus Unum]

I never take acetaminophen or ibuprofen, just aspirin.

The only reason acetaminophen and ibuprofen were invented was so they could be under patent and cost more, but the patents on both ran out long ago.

Aspirin works better and is safer.

[steveo]

Just yesterday I was picking up an Rx for small amount of Norco. It was last filled 90 days ago (qty 15, same as before). I was cleared through statewide tracking system (CURES) for this Rx.
But yet the pharmacist questioned why I changed doctors 30 days ago thinking I was on opioid seeker for a prescription filled back in early February. The paranoia runs deep.

[KC Burke]

I wasn’t under this protocol when MD Anderson removed my stomach and 15 surrounding lymph nodes for stomach cancer two years ago. I rarely pushed the pain medication bump-button. I marveled at how modest the pain was during hospital recovery and afterward. I was sent home with strong pain medication and never used it.

Massive incision is hardly visible now. A top surgeon is a true blessing. Especially if he follows a dedicated Oncologist.

[algore]

Liver transplants are very profitable,

[House Atreides]

When I was in post op recovery for total replacement knee surgery the IV opiates they gave me were only minimally effective. They stopped that and administered IV Tylenol (Acetaminophen) which was much better… at least for me. YMMV of course.

[packagingguy]

Last month I had a procedure and they gave me fentanyl and some sort of tranquilizer. I didn’t feel anything. That was odd.

[Jemian]

Acetaminophen does absolutely NOTHING for my pain. I wish these so-called “healers” would try this remedy on themselves first. Perhaps then they would understand a little more what intense pain is.

[the OlLine Rebel]

I am still highly suspicious of Tylenol.

Tylenol promoter scared us all so much about aspirin that even I am reticent to give my now-teen son aspirin.

Even more absurd, it’s become the med for heart problem prevention. Stupid commercial about a guy on a plane with pain rebuffs the stewardess who offers aspirin, saying, “I’m not having a heart attack”! Is it really that bad that people think it’s just a clot preventative etc?

All this so Tylenol could take its place on the shelf and get all the money.

[cherry]

I'll bet these surgeons not prescribing pain pills don't have surgery themselves without a nice stash or allow their families of friends to go without....

I just love it how some doctors can project what our pain will be....

I had this youngish female doctor tell me that HER husband has arthritis and knee pain but he doesn't need to have a parking pass....me being about 35 yros older and having worked a physical job all my life.....

[khelus]

ROFL

[PghBaldy]

I agree. It is garbage.

[MayflowerMadam]

“Aspirin works better and is safer.”

I prefer aspirin, but with blood thinners NSAIDs are taboo. It’s acetaminophen or nothing. Fortunately, I rarely have to take anything for pain.

[sumuam]

I’m not going back to the doctor. He recommended surgery, for a degenerative disc, and most of the time I hear surgery can make it worse. The medical marijuana here is way too expensive, and is a racket in Louisiana. THC 0 has been great for my back pain, along with kratom, and I can finally sleep.

[ConservativeMind]

If you have a bad disc, a disc replacement is a better option than a fusion.

Please look at that, since you have chronic pain. It is practically outpatient surgery and a coworker was walking around the next morning after having it as outpatient surgery and being driven home.

Fusions create problems in neighboring discs by about the ten year mark, for many, and studies have shown this.

[sumuam]

If you have a bad disc, a disc replacement is a better option than a fusion.

---

Thanks, I’ll keep that in mind, and research it. I’ve had a bad disc since my 20s from an epidurel, (never had back pain before) and it’s getting worse as I get older.

[Chad C. Mulligan]

Acetaminophen does absolutely NOTHING for my pain. I wish these so-called “healers” would try this remedy on themselves first. Perhaps then they would understand a little more what intense pain is.

Double dittos. For seven years now they've tried everything under the sun for my chronic low back pain, including a rather traumatic laminectomy last November. The ONLY thing that has made life livable has been opioid medication. Yes, I take MiraLAX a lot.

BTW the LAST thing you want in your bloodstream before or after surgery is NSAIDs. They interfere with healing.

[The Great RJ]

Last summer I had eye surgery to correct my drooping eye lids. I had incisions on both eye lids as well as brow lift. While my surgeon prescribed opioid pain medication, he started me on high doses of acetaminophen immediately after the surgery and advised me to continue taking acetaminophen for the first 48 hours and only use the opioids if needed. I never needed the opioids.