Anesthesia providers turning to non-opioid alternatives

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KNOXVILLE, Tenn. (WATE) – A Stanford University study found that having surgery heightens the risk of becoming a chronic opioid user, and it’s prompting anesthesia providers to turn to non-opioid alternatives in the operating room.

“We know that opioids are a dangerous medication,” Jason Buehler, a UT Medical Center anesthesiologist and assistant professor in the anesthesiology department, said. “They’re effective for pain control, but they’re one of the most common reasons that we see bad outcomes in the hospital.”

For the past five to ten years, he said UT Medical Center has been looking into alternatives to opioids when controlling a patient’s pain during surgery.

“We know that nationally the numbers range from 1-in-6 to 1-in-10 folks will end up on chronic opioids after surgical exposure,” he said. “We’re trying to stem that tide and reduce the amount of opioids folks are getting so that hopefully by six months they’re off of those medications altogether.”

Dr. Buehler said the hospital is incorporating those non-opioid alternatives during surgery by reducing the amount of fentanyl, an IV Opioid more powerful than heroin, that’s typically administered with anesthesia.

“The advantage of Fentanyl is that it’s a quick acting medication, so we try to give it when necessary and the advantage is that it wears off relatively quickly to where we’re able to control pain quickly,” Dr. Buehler said. “The downside is that we are exposing folks to opioids and so we’re focusing more on avoiding having to use the fentanyl and using things like dilaudid during the perioperative period and leaning more on things like nerve blocks and other non-opioid options.”

He said while nothing reduces the pain like opioids, there are a number of alternatives that can be used before and after surgery, including nerve blocks, which act similarly to a Novocain, and even Tylenol.

The changes are in an effort to help reduce the number of surgical patients who end up chronic opioid users, while ensuring a safe and comfortable experience for those undergoing surgery.

“It doesn’t mean that we’re avoiding pain control,” Buehler said. “It means that we’re looking at alternatives, so we’ve been rolling out new alternatives at the University of Tennessee. We’re using a combination of multiple different medications to help with the pain. Fentanyl and opioid are still a mainstay for pain control in the post-operative period  but you’re seeing more medications being added to reduce the amount of exposure patients have to those.”

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