Opioid medications can play an important role in managing pain after surgery. However, with the opioid epidemic that’s sweeping the nation, healthcare providers are using new approaches, including minimally invasive surgery, to reduce the need for prescription pain medications.
Reducing trauma and speeding recovery times
Unlike traditional open surgery that generally requires larger incisions and the likelihood of tearing or cutting through muscle, minimally invasive surgery (also called laparoscopic surgery) is far less intrusive. Specially trained surgeons use the latest medical technologies and equipment, including computers and miniature instruments, to operate on patients. Robotic surgery takes the benefits of laparoscopic surgery a step further, using more flexible surgical instruments that afford even greater articulation and precision to better mimic open surgery.
Whether laparoscopic or robotic, these advanced minimally invasive surgical techniques are less traumatic than open surgery. They also result in smaller incisions, less inflammation, limited disruption to nearby tissues and organs, and less blood loss.
Albert Amini, MD, a general surgery and surgical oncology physician at HonorHealth, says patients often experience less pain, shorter recovery periods, and reduced need for prescription pain medication with minimally invasive surgery.
‘You develop tolerance to narcotics within taking just a few pills’
While pain tolerance, medication needs and the number of pills required to ease pain varies from person to person, Dr. Amini says there can be a big difference in the number of prescription pain pills needed for the same procedure based on how it’s performed.
Citing a simple hernia operation as an example, he says open surgery would likely require 5-7 days of prescription opioids – roughly 30 pills. When the same procedure is performed laparoscopically, a patient may only need about 10-15 pills. Using robotic surgery, a patient may not need anything stronger than acetaminophen or ibuprofen.
Since a person’s tolerance to narcotics increases with each exposure, the fewer pills needed for pain relief the better.
“You develop tolerance to narcotics within taking just a few pills,” Dr. Amini explains. “Even short-term use can increase the risk of opioid dependence down the road. That’s why opioid users require higher doses with each subsequent operation or medical event in order to quell their pain.”
Balancing pain relief with function
Despite the potential dangers, Dr. Amini says there is a time and place for prescription narcotics like methadone, oxycodone and hydrocodone.
“If a person is in a lot of pain and they’re not eating, not walking and so on, that’s counter-productive to the recovery process,” he notes. “However, if they’re taking narcotics and end up sleeping all the time, then that’s not proper healing either. Ideally, the goal is to appropriately control pain in a manner that enables the patient to still do things and function.”
Dr. Amini says there isn’t an ideal number on the pain scale that dictates whether prescription opioids are necessary. It’s based on the individual needs and circumstances of each patient. What holds true across the board is that the sooner a patient can get off prescription pain medication, the less likely they are to develop a dependence.
In addition to the risk of opioid dependence or addiction, prescription narcotics come with a range of side effects. Even when taken properly under the direction of a physician, these drugs can result in constipation, nausea, vomiting, dizziness, confusion, depression, itching, sweating, and more.
*U.S. Department of Health and Human Services
** According to recent studies