SALT LAKE CITY — In a continued effort to reduce opioid prescriptions, Intermountain Healthcare is the first healthcare system in Utah to establish an opioid-free surgery program for patients interested in alternative pain control methods.
The opioid-free surgery program may be requested by patients at Intermountain hospitals in Utah and Idaho.
As part of a pilot project, the new program was tested for three months in which physicians used non-addictive and less addictive pain management alternatives for patients going through surgery.
The benefits of this program included a reduction in the average length of hospital stays, and a reduction in post-surgical complications, and a lower potential risk of opioid addiction. Also, patients reported overall lower pain levels.
The opioid-free surgery program has been met with very positive feedback from patients.
Dr. William Shakespeare says previously before the program, they would give patients some pills before surgery and more after. Now they are trying more targeted nerve blockers during surgery, and anti-inflammatory and non-narcotic medications instead.
“In some cases, such as heart surgery, opioid-free surgery wouldn’t be an option. In all cases where opioid-free surgery is appropriate, it requires a willing surgeon and anesthesiologist, a compatible procedure, and above all a patient who wants an alternative approach and is motivated to follow an opioid-free operative course. It’s definitely a team approach” he said.
How the Opioid-free program works:
– Educate the patient and their families so they have a clear understanding of the risks of opioids and expectations about pain management post-surgery.
– Have a patient start taking Tylenol the night before they come in for surgery.
– When patients are in the preoperative area, give them a combination of non-narcotic medications, like another dose of Tylenol, an anti-inflammatory drug like Celebrex, and a nerve-modifying agent.
– Use regional anesthesia such as nerve blocks and/or spinal-epidural anesthesia.
– Use non-opioid pain medicines such as Dexmedetomidine, Ketamine, Dexamethasone, Esmolol, and other agents that have been shown to decrease postoperative pain.
– Use long-acting anesthetics.
– Use a pain pump. This is where a catheter is placed at the affected nerve site during surgery. Patients then take the device home and when needed can pump medication directly into the painful area.
– Train patients in alternative pain management techniques, such as mindful breathing, focus management, and yoga exercises that can help them prepare for surgery and the recovery process.
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