No painkillers needed in this regimen after common sports surgeries

Painkillers are not necessarily a must to help with pain after orthopaedic surgery. — TNS

A pain management regimen without opioids (painkillers) offered the same pain relief as common prescription opioids, according to two recent studies of common sports surgeries.

Opioids can help people manage pain, but they can be addictive.

In the United States, opioid prescriptions rose from 76 million in 1990 to a peak of 255 million in 2012.

Between 1990 and 2017, deaths related to opioids increased sixfold.

The challenge for surgeons is to minimise opioid use while optimising patients’ pain control after surgery, says Mayo Clinic orthopaedic surgeon and sports medicine specialist Dr Kelechi Okoroha.

Dr Okoroha is also the senior author of both studies.

Orthopaedic and spine conditions account for about three in 10 opioid prescriptions, so surgeons can significantly decrease opioid-related deaths by limiting such prescriptions, he says.

The researchers created an approach to managing pain that eliminated opioids after common sports surgeries.

In the first study, participants had undergone knee surgery to reconstruct their anterior cruciate ligament (ACL).

In the second study, participants had undergone surgery to repair their rotator cuff.

All received a nerve block before surgery.

In each study, one group of participants received a standard opioid regimen to manage pain.

The other group took part in a pain management approach without opioids.

The non-opioid regimen included pain relievers, non-steroid anti-inflammatory drugs (NSAIDS) and muscle relaxants.

Both studies found that the non-opioid regimen provided at least the same, if not more, pain control and patient satisfaction, compared with the standard opioid regimen.

In both studies, the most common side effects were drowsiness, dizziness and gastrointestinal symptoms.

In the rotator cuff study, participants who received the non-opioid regimen reported slightly lesser side effects than those who received the opioid regimen.

Dr Okoroha says one way Mayo Clinic is working to limit opioids is by offering patients alternatives to traditional pain management.

“I think this is really game-changing research,” he says.

“We’ve found that it is effective in common sports surgeries.

“So our plan is to implement it in other surgeries, and hopefully, decrease the opioid burden worldwide.” – By Rhoda Madson/Mayo Clinic News Network/Tribune News Service