HealthDay Reporter
TUESDAY, Nov 23, 2021 (HealthDay Information) — Addictive opioid painkillers aren’t the one possibility for sufferers looking for aid following anterior cruciate ligament (ACL) knee reconstruction, researchers say.
As the USA wrestles with skyrocketing charges of opioid abuse and drug overdose deaths, the findings might come as excellent news.
After ACL surgical procedure, Advil and different nonsteroidal anti-inflammatory medication (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 examine concluded.
“Opioid medicines will be useful in managing excessive ranges of ache when appropriately prescribed,” defined examine co-author Dr. Kelechi Okoroha. He’s an orthopedic surgeon and sports activities damage specialist with the Mayo Clinic in Minneapolis.
“Nonetheless, when used for lengthy durations of time, opioids will 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 the USA 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 12 months. And greater than three-quarters of those deaths have been attributed to opioid use alone.
For many individuals, opioid addiction begins with respectable prescription painkiller use after surgical procedure. Orthopedic and backbone situations account for almost 28% of all opioid prescriptions issued in the USA, the analysis workforce mentioned in background notes. That has led consultants to hunt safer technique of minimizing post-surgical discomfort.
ACL surgical procedure is a standard operation, and “knee surgical procedure could cause excessive ranges of ache,” Okoroha mentioned.
However the excellent news is that the brand new examine reveals that “with acceptable multimodal administration, we are able to make this ache tolerable,” whereas eliminating opioid use, he added.
The findings have been revealed on-line not too long ago within the American Journal of Sports activities Drugs.
For the examine, Okoroha’s workforce examined their ache administration protocol with 34 sufferers who underwent ACL surgical procedure between February 2019 and January 2020.
All have been provided opioid-free ache medicines post-op, together with NSAIDs, acetaminophen and muscle relaxers. Ache ranges 10 days after ache therapy started have been in contrast with these of 28 different sufferers handled with an opioid medicine.
The investigators decided that ache aid was the identical throughout each teams, with no considerable variations by way of unwanted side effects (habit danger apart), even after accounting for age, gender and physique mass index (a regular indicator of weight problems standing).
The findings do not shock one knowledgeable who was not a part of Okoroha’s examine workforce.
“I’ve truly had each of my ACLs reconstructed, so I do know the related ache nicely,” mentioned 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 rapidly transitioned to non-opioid therapy.”
That therapy went past medicine. “An automatic, cooling compress across the surgical website offered the best aid,” mentioned Katz.
“Based mostly on private expertise, I’m not in any respect shocked that opioids will be omitted from the routine, whereas preserving comparable ache administration,” he added.
Nonetheless, Katz expressed some reservations concerning the present examine’s strategy.
“The routine on this examine doesn’t impress me all that a lot, to be brutally trustworthy,” he mentioned. “It avoids opioids, which will be dangerously habit-forming, however features a benzodiazepine (Valium), which will 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 nicely. Really ‘multimodal’ ache aid isn’t just totally different medicines. It ought to embody non-medication choices that work, too,” he urged.
Nonetheless, Katz did not dismiss the work totally. “Usually, opioids are overused, whereas plenty of continual ache is undertreated. So there’s actually a have to broadcast any advance that may assist tackle these twin threats,” he mentioned.
Extra data
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 damage 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
