Opioid-free general anesthesia is safe, effective and dramatically decreases postoperative nausea. A single-center study of more than 1000 patients is presented at the ANESTHESIOLOGY 2017 annual meeting.
The TEAM Health Anesthesia at Select Physicians Surgery Center used opioid alternatives during general anesthesia to reduce the use of opioids during and after surgery. The physician anesthesiologists promote pain management alternatives to opioids and make headway in reducing the use of the addictive medications.
The study findings suggest that, "Opioids crept into general anesthesia over the years because they don't cause problems with the cardiovascular system, but our research suggests we can use alternatives safely and effectively".
In this study, a total of 1,009 patients having head and neck surgery were given general anesthesia without opioids. Instead of that the patients were given various combinations of magnesium, sub-anesthetic ketamine or magnesium depending on age and health.
The study reported satisfactory results with the new anesthesia protocol and postoperative pain management. There were positive outcomes associated with the use of non-opioids. Among all patients, only 11% experienced nausea, whereas 50-80% of patients suffer from nausea after surgery. Additionally, 64% of patients did not require any pain medication in the PACU.
Not using fentanyl during surgical anesthesia and not providing patients too many pills after surgery might decrease the likelihood of opioid abuse. Studies show that 1 in 15 patients who have surgery are still taking prescription opioids 90 days afterwards due to opioid addition.
Three among 19 surgeons in the study prescribed daily oral magnesium, gabapentin and ibuprofen for pain management after surgery. They also prescribe five hydrocodone pills (opioid medication) for any breakthrough pain. Previously, these surgeons prescribed 50 hydrocodone pills. The change to five pills will lead to 27,000 fewer prescribed hydrocodone pills in one year's time for these surgeons at their practice.
In future, the researchers plan to study whether avoiding opioids during surgery and reducing opioid prescriptions after surgery resulted in reducing opioid use and abuse.
Opioid-free general anesthesia is safe, effective and dramatically decreases postoperative nausea and decreases the risk of drug abuse.