Pain management is an important consideration when you’re having surgery – not only to minimize discomfort, but also because good post-operative pain control plays a vital role in optimizing your recovery. The sooner you are able to get up and about, the less likely you are to develop complications like blood clots, hospital acquired infections, and respiratory problems.
But with the opioid crisis in the news, you may be concerned about how to recover from your upcoming surgery without the risk of getting addicted to painkillers. And you’re wise to be cautious – according to a study done at University of Michigan, 6% of people who were prescribed opioids for post-surgery pain were still getting the drugs three to six months later. So, how can you prevent this from happening to you?
Fortunately, there are ways of improving post-operative pain control while lessening the risk of addiction. Here are some options to discuss with your physicians that may apply to your particular situation:
- Multi-Modal Analgesia – This is a term developed by anesthesiologists to describe a pain control strategy that utilizes two or more different types of medications, with a goal of minimizing side effects and preventing an over-dependence on opioids for relief. For example, instead of just taking an opioid painkiller after surgery, other classes of medications like acetaminophen and nonsteroidal anti-inflammatory medications (like ibuprofen) can be added to the mix. And other novel classes of medications, like gabapentin and ketamine, can be added at the time of surgery to diminish post-operative pain levels.
- Regional Anesthesia – In some cases, a nerve block can be performed by your anesthesiologist before your surgery to help decrease the amount of pain medication required right after surgery. Regional techniques, including the use of epidural catheters, are especially helpful for certain orthopedic surgeries, as well as surgeries involving opening up the chest wall or abdomen.
- Mind/Body Approaches – There is a lot more to pain management than just medication, even when it comes to treating post-operative pain. Relaxation training, meditation apps, music, and even virtual reality have been shown to lower the need for painkillers. In some cases, hands-on therapies like massage and acupuncture can also help reduce pain and swelling. Don’t be afraid to think outside the box!
When you do need to use opioids, exercise caution and be aware of the risk factors for addiction. One factor that seems to greatly impact the risk of opioid dependence after surgery is the number of days that someone remains on opioid painkillers. There doesn’t seem to be a particular risk after the first few days of having surgery, but once you get to around the fifth post-operative day, the odds of staying on opioids long-term goes way up. Certainly, each situation poses unique circumstances. After all, there is a big difference between cataract surgery and a spinal fusion, but if you want to play it safe, try to avoid being on opioids beyond the first 3-5 days after surgery if possible (and have the doctor prescribe only enough pills for the first few days). Other factors than can increase your risk for becoming dependent on painkillers after surgery include a past history of addiction, depression, or anxiety, and tobacco use.
To make sure you have the most effective, and the safest, post-operative pain control, talk to your doctor ahead of time. Don’t wait until the day of surgery to have the discussion. Having a plan in advance will allow time for coordination to take place between your surgeon, the anesthesiologist, and the facility where the surgery is taking place.