New study highlights how pain management practices are changing after surgery

Although there has been no decrease in the number of opioid prescriptions seniors receive after surgery, the doses of those prescriptions are lower, according to a study of more than a quarter million Canadian patients being presented at the ANESTHESIOLOGY® 2022 annual meeting.

While it's good news that the doses in opioid prescriptions are being reduced, the fact that the actual number of opioid prescriptions filled has remained the same shows there is still an opportunity for improvement. That's particularly true for procedures associated with low postoperative pain that can be effectively controlled with non-opioid medications such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs)."

Naheed Jivraj, MBBS, MS, FRCPC, Lead Study Author and Critical Care Medicine Fellow, University of Toronto, Ontario

While opioids can be an important part of pain management after surgery, limiting their use, including by lowering the dose, is important since they can cause major side effects and lead to addiction, as well as a potentially deadly overdose.

To assess trends in filling pain prescriptions in the week after surgery, the researchers studied the records of 278,366 patients representing all adults in Ontario older than 65 who had one of 14 surgical procedures between 2013 and 2019. The surgical procedures in the study included: thyroid removal, appendix removal, hernia repair, laparoscopic or open removal of the gallbladder, removal of the prostate, open-heart surgery, laparoscopic or open colon removal, laparoscopic vaginal or abdominal hysterectomy, removal of the breast, hip replacement and knee replacement.

They identified an increase in patients filling non-opioid prescriptions (e.g., acetaminophen or NSAID) from 9% in 2013 to 28% in 2019. They found most patients also continued to receive a prescription that contained an opioid -; 76% in 2013 and 75% in 2019. However, the dose of the opioid prescriptions decreased, from an average of 317 MME (morphine milligram equivalent) in 2013 to an average of 260 MME in 2019.

Most patients undergoing procedures such as removal of the appendix or thyroid can get pain relief from acetaminophen or an NSAID; however, few patients who had these procedures filled prescriptions for those non-opioid alternatives, researchers noted.

"Our study highlights how pain management practices are changing after surgery," said Dr. Jivraj. "The increase in seniors filling non-opioid prescriptions and the lower opioid dose may reflect the development of surgery-specific prescribing guidelines and the increasing use of anesthesiologist-championed Enhanced Recovery After Surgery protocols and other programs that focus on improving patient outcomes."


  1. Kevin L Kevin L Netherlands says:

    Another "study" angle... bought & paid for by what entity? I do not see the credits for the funding.

    One thing we all know -- each person has differing experiences with marijuana vs pain. Like any prescription drug or alcohol, every body processes it in its own way.

    Bottom Line Result:  Some people receive pain relief from marijuana; some do not.
    Some experience a degree of intensified pain; some do not.

    Sorry, but this limited research is far from convincing of anything at all. Although I'm almost convinced to apply for research/study funding!!

    This Study Rating = Zero

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
Post a new comment
You might also like...
Trajectory of fear of cancer recurrence levels six to 18 months post-breast cancer diagnosis