Reduced opioid use in surgery linked to improved pain scores

After anesthesiologists at the University of Virginia Health System in Charlottesville began administering fewer opioids to patients during surgeries, patients' self-reported pain levels dropped, according to a study led by three UVA anesthesiologists.

For the study, the team examined 101,484 surgeries that took place in the UVA Health System from March 2011 to November 2015. During this time period, the amount of opioids administered via general anesthesia at the system was reduced by 37 percent.

For the same time period, self-assessed patient pain scores recorded in post-op recovery units dropped from an average of 5.5 on a 10-point scale to an average of 3.8, marking a 31 percent improvement.

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One of the study's leaders, UVA anesthesiologist Marcel Durieux, MD, PhD, said the impetus behind the pain score improvements is likely attributable to several factors. One, previous research has indicated opioids can ultimately make people more sensitive to pain. And two, the increased use of non-opioid painkillers like lidocaine and acetaminophen during surgeries at UVA was likely effective.

During the study period, use of these painkillers jumped by 120 percent. While these medications cannot be used by all patients due to medication-specific sensitivities, they carry a much lower risk of addiction.

"There is very clear evidence that people can become opioid-dependent because of the drugs they get during and after surgery," said Dr. Durieux. "I think that by substantially limiting opioids during surgery, we've made an important step in addressing that problem."

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