Opiod Sparing Post-Operative Pain Control
Our priority is safe and effective control of your post-operative pain.
The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing medications to work together while requiring lower total doses of each drug.
Reasons for opioid sparing/multimodal pain protocols:
- Societal:
- Opioid overdose is the leading cause of accidental deaths in young adults, surpassing motor vehicle accidents
- The U.S. consumes approximately 80% of all opioids made throughout the world, while only comprising 5% of the world population
- Orthopedic Surgeons are the third leading prescriber, behind primary care physicians and internists
- 2/3rds of the prescribed number of pain pills are left unconsumed by hand surgery patients
- Patient specific:
- Side effects of opioid pain medications include: inability to perform work, loss of cognitive function, or life-threatening respiratory depression (overdose)
- 13% of opioid-naive patients continue to fill opioid prescriptions 3 months after surgery
- A greater amount of initial opioid exposure (higher total dose, longer duration prescription) is associated with greater risks of long-term use, misuse, and overdose
Everyone’s response to pain is different, and pain control regimens must be tailored to the patient and the situation. Research and clinical experience, however, provide the framework for appropriate post-operative pain control protocols.
If you are going to be undergoing a surgery that involves the upper extremity, a multimodal approach will be planned to address your pain including local/peripheral anesthetics (such as an upper extremity block) and non-opioid medications as deemed appropriate. Soft tissue surgeries tend to be less painful than those involving the bones. If opioid pain medications are necessary we will provide the lowest dose and duration prescription that will allow for appropriate pain relief. Opioid pain medications are designed to be used for break through pain that is not satisfactorily controlled by the non-opioid medications in your pain regimen. Our goal will be for you to have transitioned to a non-opioid pain control regimen by day 5-7 after surgery. Pain following small soft tissue procedures can often be appropriately treated without the need for opioid pain medications.
