Opioids May Not Be Wanted After Knee Surgical procedure

By Alan Mozes
HealthDay Reporter

TUESDAY, Nov 23, 2021 (HealthDay Information) — Addictive opioid painkillers aren't the one possibility for sufferers in search of reduction following anterior cruciate ligament (ACL) knee reconstruction, researchers say.

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

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

"Opioid drugs could be useful in managing excessive ranges of ache when appropriately prescribed," defined research 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 intervals of time, opioids could be addicting," Okoroha cautioned. And "when used incorrectly, or in excessive doses, opioids can have unwanted side effects, together with drowsiness, confusion, slowed respiratory and even dying."

Drug overdose deaths in america 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% soar over the prior yr. And greater than three-quarters of those deaths had been attributed to opioid use alone.

For many individuals, opioid addiction begins with professional prescription painkiller use after surgical procedure. Orthopedic and backbone situations account for practically 28% of all opioid prescriptions issued in america, the analysis group stated in background notes. That has led specialists 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 ache," Okoroha stated.

However the excellent news is that the brand new research reveals that "with acceptable multimodal administration, we are able to make this ache tolerable," whereas eliminating opioid use, he added.

The findings had been printed on-line just lately within the American Journal of Sports activities Drugs.

For the research, Okoroha's group examined their ache administration protocol with 34 sufferers who underwent ACL surgical procedure between February 2019 and January 2020.

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

The investigators decided that ache reduction was the identical throughout each teams, with no considerable variations by way of unwanted side effects (dependancy threat apart), even after accounting for age, gender and physique mass index (a regular indicator of weight problems standing).

The findings don't shock one skilled who was not a part of Okoroha's research group.

"I’ve really 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 Heart, in New Haven, Conn. "I imagine I used opioids for a day or two each instances, after which shortly transitioned to non-opioid remedy."

That remedy went past remedy. "An automatic, cooling compress across the surgical web site supplied the best reduction," stated Katz.

"Based mostly on private expertise, I’m not in any respect shocked that opioids could be omitted from the routine, whereas preserving comparable ache administration," he added.

Nonetheless, Katz expressed some reservations concerning the present research's method.

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

"As the location begins to heal, there’s a case for light therapeutic massage as properly. Actually 'multimodal' ache reduction is not only totally different drugs. It ought to embrace non-medication choices that work, too," he recommended.

Nonetheless, Katz didn't dismiss the work completely. "Generally, opioids are overused, whereas a whole lot of continual ache is undertreated. So there may be actually a must broadcast any advance that may assist handle 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 Heart, New Haven, Conn.; American Journal of Sports activities Drugs, Oct. 20, 2021, on-line


The information provided about this medicine is based on the medical literature of the medicine, however, it does not constitute a substitute for consulting a doctor.

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