As doctors, our goal is to provide patients with the best care possible, from the moment they hobble into our office until they’ve achieved maximum recovery. During this time, we also want to make sure they are as comfortable as possible, but this isn’t always easy, because comfort and full healing don’t always go hand in hand.
What we mean is that while we have a host of medications and opioids that can help you manage pain after an operation, opioids have plenty of negative side effects. The more comfort we provide, the more problems we may be causing for the patient’s rehab. It’s a difficult balance to maintain, but medical science is helping doctors do more for their patients.
Limiting Opioids Post-Op
Orthopedic surgeons at Hackensack University Medical Center have been conducting research on how to best manage pain postoperatively without opioids for procedures like joint replacement or revisional surgeries. Instead of using one opioid to provide pain relief, they are trying a combination of alternative pain management strategies that begin well before you end up on the surgery table.
For example, some programs have had success by asking patients to ween off of pain management medications prior to undergoing an operation. Patients who aren’t currently taking medications are less likely to pursue opioids post-op. Additionally, researchers are asking patients to commit to a healthy diet and exercise plan before surgery, as these factors will be helpful for recovery and pain management after surgery, so getting into a routine before you go under the knife leads to more sustained efforts.
Getting to a healthy place prior to surgery is only part of the equation. Post-op care usually involves more acute discomfort, so this is a bigger challenge for doctors and patients to overcome. Some treatment strategies they’ve found successful include:
- Intravenous NSAIDs
- Using several non-opioid agents during and after surgery, instead of a singular, more potent opioid.
- Patient education – The goal is to make pain manageable for therapy, not eliminate it altogether.
- Early physical therapy and walking exercises
- Postoperative nerve blocks for pain management at the most uncomfortable stage
- More hands-on transitional care
Opioids certainly play a role after some major surgeries, but both patients and providers should be looking for other methods to manage pain, because used incorrectly, opioids can lead to addiction and even death. On a less serious scale, they can have side effects that inhibit your desire to fully participate in your rehab program, which can limit your full recovery after an operation. Both patients and providers need to work together to find pain management solutions that avoid opioid reliance when possible following an operation.
