Patient-centered pain management

for general surgery

Opioid therapy holds an established place in postoperative pain management. But because of the adverse events and risks associated with them, is it time to look for new alternatives?

Navigating the crisis

America’s problem with opioids has reached epidemic proportions and been labeled a national emergency. Though the times call for science-based solutions and evidence-based practice, the societal panic and political soapboxing has drowned out some of the most important voices: those of the doctors.

Particularly for surgeons—who see their patients as individuals rather than statistics and know how painful procedures can be—it can be difficult to strike a balance between hospital protocols, state regulations, and patient well-being and satisfaction.

Many patients, frightened by what they have heard about the risks of opioids, may request nonopioid pain relief.1 But they still expect their pain to be managed, and depending on the type of surgery, may even expect their pain levels to improve with surgery.2

How surgeons can aid their patients in a complicated pain management climate

  • Managing expectations. After a painful procedure, it is very difficult to safely achieve zero pain. A goal should be to keep pain at a tolerable level while the patient heals.
  • Local anesthetics can be a first line of defense. Local anesthetics help patients wake up from surgery with less severe pain, and blocking the transmission of peripheral pain signals may reduce the risk of persistent postoperative pain and opioid dependence.3
  • Manage inflammation. Inflammation is a significant driver of discomfort, and can even inhibit the efficacy of local anesthetics.4-6

Learn more about postoperative pain »

Top Procedures

  • Cholecystectomy
  • Hernia Repair
  • Appendectomy

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References: 1. Graczyk M, Borkowska A, Krajnik M. Why patients are afraid of opioid analgesics – study on opioid perception in patients treated for chronic pain. Polish Archives of Internal Medicine. February 2017. doi:10.20452/pamw.4167. 2. Mancuso CA, Reid M, Duculan R, Girardi FP. Improvement in Pain After Lumbar Spine Surgery. The Clinical Journal of Pain. 2017;33(2):93-98. doi:10.1097/ajp.0000000000000383. 3. Chapman CR, Vierck C. The transition of acute postoperative pain to chronic pain: an integrative overview of research on mechanisms. J Pain. 2017;18(4): 359.e1–359.e38. doi:10.1016/j.jpain.2016.11.004. 4. Woolf CJ. Pain: moving from symptom control toward mechanism-specific pharmacologic management. Ann Intern Med. 2004;140(6):441-451. doi:10.7326/0003-4819-140-8-200404200-00010. 5. Hargreaves KM, Keiser K. Local anesthetic failure in endodontics: mechanisms and management. Endod Topics. 2002;1(1):26-39. doi:10.1034/j.1601-1546.2002.10103.x. 6. Becker DE, Reed KL. Essentials of local anesthetic pharmacology. Anesth Progress. 2006;53(3):98-109. doi:10.2344/0003-3006(2006)53[98:EOLAP]2.0.CO;2.