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."

[BiteYourSelf]

So,instead of getting you hooked on pain killers they destroy your liver instead.🙄

[43north]

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

Not right away. It takes a few days for acetaminophen to kill your liver. They give you the IV NSAIDs to kill your kidneys. Its kind of a package deal...

[zeestephen]

Re: "Acetaminophen does absolutely NOTHING for my pain"

Oral Acetaminophen?

They are talking about intravenous Acetamin., which they give you before they close the incision.

It reduces swelling and pain at the surgical site.

I have had two hernia operations with local anesthetic only, followed by intravenous Acetamin.

Besides a slight ache and some slight stretching pain, I had zero post-op pain and swelling, both times.

That was unheard of 20 years ago. I cannot believe it has taken two decades for patients and doctors to catch on to this.

If they use local anesthetic to block surgical site pain signals from reaching your spinal cord during the operation, your post-op pain will go down 90%.