Posted on 10/04/2022 6:53:07 PM PDT by ConservativeMind
Patients can recover from orthopedic surgery just as well without using opioid-based painkillers.
Study results showed that by prescribing a combination of three non-opioid painkillers to patients, researchers successfully reduced approximately tenfold the amounts of opioids consumed over a six-week post-operative period, without altering their pain levels.
Co-principal investigator Olufemi Ayeni and his team gleaned their results by enrolling 193 patients between March 2021 and March 2022.
The patients were randomly assigned to either a control group of 98 receiving standard opioid-based painkillers or an opioid-free group (93) receiving a combination therapy of naproxen, acetaminophen and pantoprazole and a patient educational infographic. The opioid-free group had access to opioid medication if it was required for pain. Each patient undergoing outpatient knee or shoulder arthroscopic surgery was monitored for six weeks after their operation.
After the six weeks, those in the control group had had an average of 72.6 mg of opioids, compared to 8.4 mg in the opioid-sparing group. Six patients in the control group and two patients in the opioid-sparing group asked for opioid medication after discharge. Difference in pain scores, patient satisfaction with care and number of adverse events were not significantly different.
"This study clearly shows that many of these surgical patients can be treated safely without opioid medications in a select population," said Ayeni.
Opioids remain the post-operative painkiller of choice for orthopedic specialists on both sides of the border, but North America's ongoing opioid epidemic is forcing a rethink among clinicians, Ayeni said, adding that orthopedic specialists at times prescribe more opioids than recommended by medical guidelines.
(Excerpt) Read more at medicalxpress.com ...
When I stopped taking them I felt a little nauseous for a couple of days, that's it.
I had a reverse shoulder replacement in September 2021 and I think my doc gave me Tramadol. I had no pain to begin with but that dang sling drove me nuts......lol
Funny you bring this up. I had orthopedic surgery to remove implants and was given muscle relaxants and some sort of NSAID.
I felt fine.
Then I got a call from the pharmacy to pick up an oxycodeine prescription about a week after surgery. I told them I didn’t want it because I thought it wasn’t supposed to hurt.
Dilaudid was the only thing that worked for me after disk surgery.
4 years later, I still hurt, over the counter stuff does not help.
I have just learned to live with the pain.
Had shoulder surgery. Needed Norco for 90 days. Mostly to get through the PT.
Either I got a lot more wimpy in three years or the shoulder surgery was a lot more painful.
After hip replacement in 2020, they gave me a prescription for some oxy-something but I never filled it. Tylenol was fine.
Pain is very individual. There is no one-size-fits-all solution. But once post-op pain becomes a problem, it takes something a lot stronger to get it under control that it would have to prevent it in the first place.
NSAIDs have lots of downsides. Besides GI you have bleeding, cardiac, allergic reaction problems.
Addiction is very rare after postoperative opioids. Addiction to opioids is only a risk in people with family or prior history of opioid addiction.
Naproxen. One dose killed my mom’s kidneys dead. She then was on Dialysis till her death a few months later.
Last year had eye lid surgery and a brow lift to correct sagging eyelids. While I had a prescription for opioids, my pain was very adequately controlled with acetaminophen. Previously I had surgery for a broken radius and had a device pumping pain medis into a nerve bundle and has only minimal need for opiates
For your standard run of the mill broken bone sure NSAIDs will probably suffice. Major orthopedic trauma not so much. I’ve been told I have an extremely high pain threshold of pain (not so much lately in my 60’s) but for my last major trauma I was on a morphine pump for 11 days, oral morphine for a month, and oxycontin for 3 months. It barely kept the pain down to a dull roar and allowed me to sleep some. After that cold turkey with no withdrawal symptoms.
Opioids are important for pain management for many conditions. TPTB are looking for excuses to remove them as therapies to make up for their failures. Who suffers if they suceeed? Only people that need them the most.
I’m scheduled for a hip replacement. I’ve had three major surgeries in the last four years and the thing I dread the most are the pain killers. I hate them. They really mess me up. So thank you for posting this.
“Life is pain. Anyone who says something different is selling something.” The Dread Pirate Roberts
May I ask what kind of disc surgery you had?
I suspect none of these physicians who do orthopedic surgery would do without at least some opioids for the first few days following surgery or an injury. Everyone thinks they can handle pain with no problem using a couple of Tylenol or muscle relaxers, until the non-stop excruciating pain hits them in the back, neck, knee, leg, ankle, etc. Then they are crying for some relief so they can at least sleep for a few hours. (Opinion based on experience after surgery).
After back surgery, they gave me some stuff call Talwin.
Produced terrible nightmares, as if I was not in enough misery.
I gather it was an “Analgesic Opioid Partial-Mixed Agonists”
whatever that means.
After my last knee surgery (#3) the doc prescribed some opiates for pain, but it turns out I didn’t like the feeling.
Ended up mostly just gutting out the pain with some aspirin and acetiminophen (or whatever the other common one is). Took a couple of weeks before I could walk without a cane.
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