Ways to Reduce Use of Pain Medication After Surgery
June 24, 2019
Your life is spent ‘on the go’. To literally keep you upright, your spine, back and neck tend to work overtime. Your spinal column bends, twists, and supports the rest of your body.
Not only that, your spine is the main protector of your spinal cord. The ligaments and muscles surrounding the spine help you move and support the spinal column.
When your neck and back are not functioning properly, you might suffer from intermittent discomfort or perhaps even constant pain. Even little changes to your neck and back can make day-to-day life difficult.
At Cornerstone, I successfully treat neck and back problems every day. I work with patients to develop a treatment plan addressing common to complex spine issues.
My goal is to help patients return to regular life with non-operative treatments first. Fortunately, about 80% of people who suffer from spine, back or neck issues do not need surgery to experience significant improvement. However, for those who do need surgery, they are in good hands – and I provide a full range of treatments to help them return to doing the things they love.
Enhanced Recovery After Surgery (ERAS)
I care about my patients deeply and want them to be successful. One of the protocols I implement to improve patient care and recovery is Enhanced Recovery After Surgery (ERAS).
I am happy to contribute to the research on ERAS that is changing current surgical protocols for the better. Some of these changes reverse ‘age old’ techniques traditionally relied on during spine surgery.
ERAS guidelines are designed to optimize patient outcomes by addressing pre-, peri-, and post-operative factors. This helps people return home and to their lives with less reliance on long-term pain medicine use. Preoperatively, we optimize physical, mental, and functional status of the patient prior to surgical intervention. We engage and educate the patient about surgical expectations. We reduce the use on intra-operative and post-operative narcotics.
The goal of the preoperative portion of the ERAS pathway is to educate the patient about surgical expectations and to maximize the patient’s physical condition prior to surgery.
During this period, patients will engage with physicians who specialize in diabetes care, nutrition management, sleep medicine, pain management and more, to ensure no pre-existing conditions interfere with the success of the surgery. For example, a patient who is already taking large doses of pain medicine before surgery would be paired with a pain management specialist to address any potential opioid dependence issues before surgery.
“Our literature has proven that surgical patients on chronic opioid medications have worse outcomes with surgery. My goal is to address your pain issues head on before surgery, during surgery, and after surgery. We only have one chance to get the surgery right. We only have one chance to get the post op rehabilitation right as well”, said Dr. Possley.
My team screens patients for sleep apnea, cardiac conditions, blood sugar problems, and other medical conditions that go undiagnosed but could pose serious health risks for patients after surgery.
The core of the ERAS surgical paradigm during spinal surgery is to minimize stress (physiological, psychological, economic, and social) that surgery places on the patient.
In spinal fusion surgery, two of the main stressors are anesthesia and postoperative pain. It is well understood that pain reduces mobility, increases anxiety, and requires significant medications. With the use of minimally invasive techniques to reduce tissue trauma in concert with long-acting local anesthetics, patients experience far less pain at the surgical site, mobilize quickly, and are discharged earlier.
Historically, patients had been placed on a controlled analgesia pump with IV opioids and were given access to these medications for at least the first 24 hours after surgery.
Our new ERAS pathway has patients walking the day of surgery, limits the use of intra and post-operative narcotics, provides IV and oral pain medications just before surgery in a multi-modal approach to pain management which limits the use of IV opioid medications.
“I have seen less opiate use in and out of the hospital due to these techniques. Patients are happier and back to their lives without increased pain levels compared to those on chronic opioid medications”, Dr. Possley.
Throughout the entire surgery process, our team uses a variety of methods to keep patients informed and connected to their surgical care.
Not only does ERAS provide this paradigm, but it excels at it. We have an opportunity to be our best in medicine and surgery and this program will continue to be a part of my approach in helping patients.
I specialize in both minimally invasive and traditional open surgical procedures including:
• Artificial disc replacement
• Anterior cervical discectomy and fusion
• Minimally-invasive lumbar fusion
• Minimally-invasive percutaneous spinal fusions
• Minimally-invasive thoracic fusion
• Minimally-Invasive tubular spinal decompression
Whether you need the latest in non-surgical options for back pain, comprehensive surgery, or anything in between, I can help. If non-surgical care doesn’t work for you, I can surgically treat nearly any spine condition, from herniated discs and spinal stenosis to tumors and rare disorders. Cornerstone back and neck pain specialists help determine the cause of your discomfort, then develop an individualized treatment plan to address your pain and dysfunction to provide relief.
Learn more about our spine, neck and back program.
At Cornerstone Orthopaedics & Sports Medicine, we continue to pursue new and innovative back pain care, offering a full range of advanced treatments for patients of all ages with all types of spine, back and neck problems. We are committed to partnering with you to determine the best possible solution for your situation.
Contact us at 303-456-6000 to make an appointment or request an appointment online.