Recovering from Surgery: Effective, opioid-free pain relief


7/26/2021

When they are recommended by a health care provider, opioids, or a type of prescription pain medicine, serve a valuable purpose to reduce pain.

However, the U.S. is struggling with an epidemic related to opioids. Misuse and abuse of prescription opioid drugs like oxycodone (Percocet), hydrocodone (Vicodin), and fentanyl has run rampant — and has also led to increased use of illegal opioids, including heroin and illicit fentanyl. The statistics paint a sobering picture.

  • Between 8 percent and 12 percent of patients prescribed opioids develop an opioid use disorder, according to a 2019 report from the National Institute on Drug Abuse.
  • Nearly 80 percent of heroin users previously misused prescription opioids, according to 2019 data from the Centers for Disease Control and Prevention (CDC).
  • An average of 130 Americans die of an opioid overdose each day, the same CDC data says.
In Massachusetts, overall deaths associated with opioids rose 5.2 percent in 2020, reversing declines in recent years, according to a report released in May by the state Department of Public Health. Opioid-related deaths jumped by 69 percent among non-Hispanic Black men.

Emerson Hospital clinicians throughout the health system are working hard to reduce the need for prescribed opioids. In addition to being highly addictive, opioids can have unpleasant side effects, such as nausea, dizziness, light-headedness, and constipation.

Exparel, an effective, long-acting local anesthetic, is now available for patients to remove or reduce the need for non-opioid pain medications, especially following surgery. Many Emerson surgeons, including those performing general, orthopedic, bariatric, plastic, and breast surgeries, now use Exparel in surgeries where patients are at least 18 years old.

In many cases, patients do not require pain medicine when they recover. However, if they do, over-the-counter pain medication, such as acetaminophen (Tylenol) or ibuprofen (Advil), usually provide sufficient relief.


What Is Exparel?

Exparel is a non-addictive, opioid-free, local anesthetic medication that is used by anesthesiologists and surgeons to provide patients with safe and effective pain control following surgery. It is used along with routine anesthetics so that patients do not feel pain during and after surgery. Doctors use two methods to administer Exparel:
  1. Nerve block: Injected by an anesthesiologist under ultrasound guidance near a nerve, usually before surgery. The nerve block will control pain for days after surgery. This is similar to epidurals that some women receive for pain relief when they are in labor, but this medication lasts much longer.
  2. Injection: Injected by a surgeon in the operating room during surgery. This numbs pain in the area of the body where the surgery is performed.
“Exparel anesthesia is a very effective way to reduce the need for narcotics and improve pain relief after surgery,” explains Gregory Gardner, DO, chief of anesthesiology at Emerson Hospital. “It is an exciting development at Emerson — it works very well. Patients are grateful they do not need opioids, and we are grateful their pain is controlled in a safe way through the duration of their recovery.”


Podcast: Substance Abuse Disorders

Stephanie Stratigos, DO, discusses substance use disorders (SUDs), including who is most at risk, warning signs and red flags, treatment options (specifically medication-assisted treatment), and what patients can expect during and after treatment.
 


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