Majority Of Post-Op Patients Managed Pain Without Opioids, Study Finds

By Kelly Burch 06/06/19

The study's lead author believes that keeping people from taking opioids for the first time could help mitigate the opioid epidemic. 

post-op patient talking to nurses

Patients who have undergone surgery may not always need opioid painkillers to manage post-operative pain, according to a new study. 

The research, which is pending publication in the Journal of the American College of Surgeons, found that a majority of patients were able to manage their pain using a regimen of over-the-counter pills.

For the study, researchers selected patients who were undergoing one of six surgical procedures. These patients were given the option to use acetaminophen (Tylenol) and ibuprofen (Advil) to control their pain. They were instructed to take an alternating dose of these over-the-counter medications every three hours. 

The patients were also given a “rescue” opioid prescription to use in case they experienced breakthrough pain and needed more relief. However, 52% of patients did not use the opioids, and 98% used 10 opioid pills or fewer. People who used the opioids needed, on average, four pills. 

“Patients reported minimal or no opioid use after implementation of an opioid-sparing pathway, and still reported high satisfaction and pain control,” study authors wrote. “These results demonstrate the effectiveness and acceptability of major reduction and even elimination of opioids after discharge from minor surgical procedures.” 

Lead study author Michael Englesbe, a professor of surgery at the University of Michigan, told Medical Xpress that keeping people from taking opioids for the first time could help mitigate the opioid epidemic. 

"We think a fundamental root cause of the opioid epidemic is opioid-naïve patients getting exposed to opioids and then really struggling to stop taking them postoperatively, and then moving on to chronic opioid use, abuse, addiction, and overdose,” he said. 

The study proves that many patients can manage pain effectively without opioids. Englesbe will now expand the research to study an additional 12 types of surgical procedures. Demonstrating that patients can manage pain without opioids could change how prescriptions are handled, he said. 

"Our overall goal is to have half the operations done in the state of Michigan without patients needing opioids and still getting excellent pain care," he said. "There are alternatives to opioids for surgical pain that work well and we should be using them more."

However, he said that this involves talking openly to patients, and realizing that in some cases opioids are needed to effectively manage pain. 

"Just not giving opioids is not the answer—we have to give the best pain care," he said. "From the beginning, everyone was on the same page with talking to patients about their pain and letting them know that operations hurt.”

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.