How surgeons are reducing number of painkillers patients need

Question: What techniques are doctors using to reduce pain after surgery?

Answer: With opioid overdoses climbing steadily in the United States over the last decade, doctors are working to identify new ways to help patients manage their pain without the use of narcotics. In orthopedic surgeries, doctors can now give patients periarticular injections at the end of their surgeries. This injection acts as a local nerve block, numbing pain in the areas around the surgery site for 24 to 30 hours, which reduces the total number of painkillers patients need during their recovery. Periarticular injections help patients feel less pain immediately following surgery and allows them to start their recovery, including physical therapy, sooner and feeling more coherent.

The injection is a combination of multiple medications including a local anesthetic and anti-inflammatories. Mountain View Pharmacy formulates each injection to meet the needs of specific patients.

Question: With periarticular injections, do patients still need painkillers following surgery?

Answer: Periarticular injections do not take patients’ pain away entirely. It is important for patients to stay on top of their pain management following surgery. I still prescribe painkillers for my patients because I want them to be as comfortable as possible following surgery.

Question: Are there other pain management techniques surgeons use?

Answer: Physicians will often use optional regional nerve blocks in their procedures, which work together with periarticular injections to reduce pain and opioid use. Nerve blocks can last up to 48 hours after surgery and help patients reduce pain without impacting their cognitive ability.

In addition to nerve blocks and injections, I have found when we use other non-narcotic medications patients don’t need as many narcotic pain pills to get through their recovery. Tylenol, anti-inflammatory medications, and oral medications that specifically target nerve pain can work together to help manage pain on several different physiologic levels in the body thus minimizing narcotic usage. More advanced cold therapy circulating devices have also worked well with compression socks, elevation and early physical therapy to reduce swelling and improve pain control.

Question: What should I do if I’m concerned about narcotics following surgery?

Answer: If you have any concerns about using prescription medications to manage pain following surgery, talk to your doctor ahead of your procedure. Together, you can discuss potential alternatives and figure out a plan that will work best for your specific needs.

Dr. Jason Dalling performs many orthopedic procedures. He carries specialized training in complex and revision joint replacement surgery. His training has also focused on arthroscopic treatment of shoulder and knee injuries as well as optimized post-operative pain control.