Does Opioid Cessation Prior to Surgery Help or Hurt? – April 4, 2017 By Thomas G. Ciccone
Patients receiving opioids prior to elective abdominal surgery had slightly longer hospital stays and were at higher risk of being discharged to a rehabilitation facility than opioid-naïve patients, according to the results of a new study.
“Chronic opioid use complicates management following surgery, and increases postoperative healthcare utilization and costs independent of other risk factors.”
None of these studies consider that opioids are prescribed for severe pain. Severe pain before surgery or unsuccessful surgery is what affects continuing opioid use. Continue reading
Acute pain management in opioid-tolerant patients: a growing challenge. – PubMed – NCBI – Anaesth Intensive Care. 2011 Sep – – Free full-text article
In Australia and New Zealand the … burden of chronic pain is more widely recognized and there has been an increase in the use of opioids for both cancer and non-cancer indications.
As a result, the proportion of opioid-tolerant patients requiring acute pain management has increased, often presenting clinicians with greater challenges than those faced when treating the opioid-naïve
Treatment aims include
Interventional Pain Management for Chronic Pain 7/18/16
Injections, Stimulation, Pain Pumps, and Other Treatments
For many people living with chronic pain, finding pain relief can be tough. A lot of trial and error is involved to find a pain treatment that works. Interventional pain management may help chronic pain patients cope with their pain.
what makes interventional pain management different is that it uses techniques, such as injections and radiofrequency rhizotomy, to directly [and invasively] address the source of your pain.
Some conditions interventional pain management techniques commonly treat include: Continue reading
I stumbled across this chart and found it interesting enough to share:
Why ‘useless’ surgery for back and knee pain is still popular – New York Times – by
Before a drug can be marketed, it has to go through rigorous testing to show it is safe and effective. Surgery, though, is different.
The Food and Drug Administration does not regulate surgical procedures.
So what happens when an operation is subjected to and fails the ultimate test — a clinical trial in which patients are randomly assigned to have it or not?
It looks as if the onus is on patients to ask what evidence, if any, shows that surgery is better than other options. Continue reading
Pain doctors: Insurance companies won’t cover the alternatives to opioids
Though the increased focus on pain treatment resulted in increases in opioid prescriptions in most doctors initially, for years now, pain specialists have advocated using alternative treatments [referring to interventional procedures, like epidurals] to alleviate their patients’ chronic pain.
There’s one problem:
Health-insurance companies are increasingly cutting reimbursements for these alternative treatments or not covering them at all.
This is partly because they haven’t been proven to be very effective. Continue reading
Interventional Treatments of Cancer Pain are Effective but Under-Utilized | June 2016 | Cindy Lampner
According to many recent studies, these lauded “interventional” (i.e. invasive, traumatic, dangerous) treatments are relatively ineffective in resolving the original pain and often create new lifelong chronic pain for patients.
Perhaps it is a blessing that they are under-utilized.
A recent review by Drs. Jill Sindt and Shane Brogan of the University of Utah School of Medicine detailed the current status of a number of interventional techniques for the treatment of cancer-related pain:
- intrathecal drug delivery,
- vertebral augmentation,
- neurolytic plexus blocks, and
- image-guided percutaneous tumor ablation
Stanford Study Says Surgery Heightens Opioid Risk – National Pain Report – July 12, 2016 – By Ed Coghlan
Stanford University School of Medicine researchers say that a study of health insurance claims showed that patients undergoing 11 of the most common types of surgery were at an increased risk of becoming chronic users of opioid painkillers.
Why does no one understand that surgery is the last resort for people with painful injuries and syndromes, and that failures of these surgeries are common and account for much chronic pain?
Opioids are usually taken for a good reason: pain.
How many patients in this study were suffering from severe pain long after their surgery? Continue reading
Is your back surgery helping your doctor more than you?
Amid concerns about mounting drug and health care costs, physicians are coming under scrutiny regarding potential financial conflicts of interest that can potentially add greatly to medical costs
Now comes a report by the Senate Finance Committee on another medical industry practice that suggests that many surgeons are lining their pockets by encouraging patients with serious back problems to undergo difficult and costly operations using devices and equipment supplied by companies with which the surgeons have a financial interest. Continue reading
Surgery increases despite failing to fix lower back pain, Medical Journal of Australia reports – smh.com.au – April 26, 2016 – Anna Patty
Surgery is failing to remedy back pain and is increasingly being used to treat other causes including depression and social isolation, medical researchers have warned.
A disproportionately high number of spinal fusions are being performed in private hospitals in response to the unrealistic expectations of patients with lower back pain.
Professor Atkinson said busy surgeons were often willing to perform an operation, despite growing evidence showing it often fails to cure back pain. Continue reading