Epidemiology: 130 deaths per day in the United States are attributed to opioid overdose (from both illicit and prescription agents); opioids accounted for >70,000 deaths in 2017; methadone, oxycodone, and hydrocodone are the most abused opioids; surgeons commonly prescribe oxycodone and hydrocodone; the National Survey of Drug Use and Health reports that ≈90% of opioids originate from physician prescriptions.
Pathway for opioid-sparing postoperative control of pain (Hallway et al, 2019): included patients undergoing 6 types of operations (including general surgery procedures, sinus surgery, prostatectomy); patients were educated that adequate control of pain can be achieved without opioids and that the goal of pain control is comfort rather than the absence of pain; scheduled doses of acetaminophen 650 mg and ibuprofen 600 mg were administered every 6 hr; rescue doses of oxycodone were provided (4 to 10 tablets, depending on the type of surgery); results — <10 tablets were taken by 90% of patients; 50% of patients took no opioids; median pain score 1; satisfaction score 10.
How to treat your pain:
1. Do not do anything that overstresses or strains the area. I.E. if it hurts, don’t do it!
2. Use the ice-water pack as needed. When the ice melts, add more.
3. Take Acetaminophen 650mg (two 325mg tablets) every 6 hours until you don’t need pain medicine. Do not take more than 8 tablets in 24 hours.
4. If you do not have any history of peptic ulcer or intolerance to NSAIDs, you should also take Ibuprofen 600mg (three 200mg tablets) every six hours. You can alternate this with the Acetaminophen or take them at the same time. These meds do not take away the pain completely, they do reduce it significantly with minimal side effects.
5. We may also give you a prescription for narcotics to be used when needed as a way to treat breakthrough pain. Narcotics have side effects that are best avoided, so only use them if necessary. Please dispose of any unused narcotics at the Pharmacy or our office.
6. You can call us with any issues that this strategy does not cover (541) 754-1286.
