Addictive Opioid Painkillers Might Not Be Needed After Knee Surgery

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News Picture: Addictive Opioid Painkillers Might Not Be Needed After Knee SurgeryBy Alan Mozes HealthDay Reporter

TUESDAY, Nov 23, 2021 (HealthDay Information) — Addictive opioid painkillers aren’t the one choice for sufferers looking for reduction following anterior cruciate ligament (ACL) knee reconstruction, researchers say.

As the USA wrestles with skyrocketing charges of opioid abuse and drug overdose deaths, the findings might come as excellent news.

After ACL surgical procedure, Advil and different nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen (Tylenol) and muscle relaxers seem to supply the identical diploma of pain management to sufferers as prescription opioids like morphine, hydrocodone or oxycodone, the small examine concluded.

“Opioid medicines will be useful in managing excessive ranges of pain when appropriately prescribed,” defined examine co-author Dr. Kelechi Okoroha. He’s an orthopedic surgeon and sports activities harm specialist with the Mayo Clinic in Minneapolis.

“Nonetheless, when used for lengthy durations of time, opioids will be addicting,” Okoroha cautioned. And “when used incorrectly, or in excessive doses, opioids can have unintended effects, together with drowsiness, confusion, slowed breathing and even demise.”

Drug overdose deaths in the USA are at an all-time excessive, the U.S. Facilities for Illness Management and Prevention reported this month — 100,000 drug-related fatalities between April 2020 and April 2021. This represents a 30% bounce over the prior yr. And greater than three-quarters of those deaths have been attributed to opioid use alone.

For many individuals, opioid addiction begins with respectable prescription painkiller use after surgical procedure. Orthopedic and backbone circumstances account for practically 28% of all opioid prescriptions issued in the USA, the analysis staff stated in background notes. That has led consultants to hunt safer technique of minimizing post-surgical discomfort.

ACL surgical procedure is a typical operation, and “knee surgical procedure may cause excessive ranges of pain,” Okoroha stated.

However the excellent news is that the brand new examine reveals that “with applicable multimodal administration, we will make this pain tolerable,” whereas eliminating opioid use, he added.

The findings have been revealed on-line lately within the American Journal of Sports activities Drugs.

For the examine, Okoroha’s staff examined their pain management protocol with 34 sufferers who underwent ACL surgical procedure between February 2019 and January 2020.

All have been supplied opioid-free ache medicines post-op, together with NSAIDs, acetaminophen and muscle relaxers. Ache ranges 10 days after ache therapy started have been in contrast with these of 28 different sufferers handled with an opioid medicine.

The investigators decided that ache reduction was the identical throughout each teams, with no considerable variations when it comes to unintended effects (addiction danger apart), even after accounting for age, gender and physique mass index (a normal indicator of obesity standing).

The findings do not shock one skilled who was not a part of Okoroha’s examine staff.

“I’ve truly had each of my ACLs reconstructed, so I do know the related ache properly,” stated Dr. David Katz, director of the Yale College Prevention Analysis Middle, in New Haven, Conn. “I imagine I used opioids for a day or two each occasions, after which rapidly transitioned to non-opioid therapy.”

That therapy went past medicine. “An automatic, cooling compress across the surgical website offered the best reduction,” stated Katz.

“Based mostly on private expertise, I’m not in any respect stunned that opioids will be omitted from the routine, whereas preserving comparable pain management,” he added.

Nonetheless, Katz expressed some reservations concerning the present examine’s strategy.

“The routine on this examine doesn’t impress me all that a lot, to be brutally trustworthy,” he stated. “It avoids opioids, which will be dangerously habit-forming, however features a benzodiazepine (Valium), which will be dangerously habit-forming. And there’s no point out of non-medication choices, such because the cooling compress I described,” Katz famous.


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“As the location begins to heal, there’s a case for light massage as properly. Actually ‘multimodal’ ache reduction isn’t just completely different medicines. It ought to embody non-medication choices that work, too,” he urged.

Nonetheless, Katz did not dismiss the work fully. “Basically, opioids are overused, whereas a whole lot of chronic pain is undertreated. So there may be actually a must broadcast any advance that may assist deal with these twin threats,” he stated.

Extra info

There’s extra on opioids and associated dangers on the U.S. Centers for Disease Control and Prevention.

SOURCES: Kelechi R. Okoroha, MD, orthopedic surgeon and sports activities harm specialist, division of sports activities drugs, Mayo Clinic, Minneapolis; David Katz, MD, MPH, director, Yale College Prevention Analysis Middle, New Haven, Conn.; American Journal of Sports activities Drugs, Oct. 20, 2021, on-line

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