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Avoiding opioids: Finding new ways of treating pain before, during and after surgery

In the wake of an epidemic of opioid addiction and deaths, there’s a growing movement among surgeons to find other ways to successfully manage post-surgery pain.

BALTIMORE — Every day in the United States, 130 people die from opioid overdose. Sometimes, the drugs are obtained illegally, or they can be prescribed by a doctor for pain relief after surgery. In the wake of an epidemic of opioid addiction and deaths, there’s a growing movement among surgeons to find other ways to successfully manage post-surgery pain.

Oxycontin, Percocet, Vicodin – for years, they were a mainstay of pain management after surgery. Plastic and reconstructive surgeon at Mercy Medical Center,  Lauren Nigro, MD said she and many of her colleagues recommend non-narcotic alternatives for patients, even for procedures that require weeks of recovery time, like a tummy tuck.

“A lot of it has to do with the size of the cuts we're making, and a lot of it has to do with also sewing those muscles together,” Dr. Nigro explained.

But Dr. Nigro said that for the past several years, there’s been a movement to treat pain before, during, and after the procedure. Before, patients are often prescribed Tylenol or another acetaminophen for several days. During, doctors administer a long-acting nerve block that can last three or four days. After, doctors sometimes prescribe gabapentin, non-steroidal anti-inflammatories, and in some cases, an injection of Botox.

“There's actually a substance in it that it inhibits the substance P, which involves the pain pathway,” Dr. Nigro further explained.

Dr. Nigro said it’s important to use the pain management methods before and during surgery, so patients are not suddenly in uncontrollable pain afterwards, which leads to taking more painkillers than needed.

Doctors do still prescribe opioids for pain relief and chronic conditions, but in some states, doctors limit the prescription to ten pills, or just a week’s worth of medication.

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