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Two New Approaches To Decrease Postoperative Pain

In this post, we are looking at two new approaches for decreasing the pain associated with postoperative procedures. What has recently been observed is that a new combination of postoperative pain treatments has been able to decrease both pain and also decrease the use of narcotic pain relievers. This news comes according to two studies presented at the 2013 Clinical Congress of the American College of Surgeons. One pain treatment utilized the simple but non-standard application of ice packs after major abdominal operations in patients, and the other treatment was a prolonged drug delivery method using nanotechnology in animals.

The standard pain-management process for most postoperative procedures has been to use opiate-based pain relieving medications (for example morphine). These medications however do have a range of side-effects on the patient, including and not limited to severe constipation, increased drowsiness/sleepiness, and if used long-term we know the potential for addiction to the medication is real. There is now evidence to suggest that narcotics like morphine and other opiate-based medications may not be the best method for treating and controlling pain.

To gain a better idea of the two new approaches, here are extracts from the research that provide an excellent understanding of each approach and the results:

New use for ice following open abdominal procedures

‘...Multiple studies have found that cryotherapy -- application of ice to the surgical wound -- is safe and effective at reducing pain after some types of operations, such as orthopedic procedures. However, researchers have not studied the use of cryotherapy in patients undergoing major, "open" (large-incision) abdominal operations, Dr. Master explained.

(From a study) The results showed that patients who used ice packs reported significantly less pain than those who did not ice their surgical wounds. On average, the cryotherapy group had about 50 percent less pain on the first and third days after the operation compared with the no-ice control group, according to the investigators. In addition, on the first postoperative day, the cryotherapy group used 22.5 percent less opioid pain medication than controls, while some patients who iced reportedly used no narcotics...’.

Prolonged delivery of lidocaine effective in animals

‘...The pain treatment utilized in the second study used a high-tech device -- nanoparticles -- to create a controlled-release delivery system for the non-opioid numbing medication lidocaine (anesthetic). Although the effects of lidocaine injections usually are short-lived, nanotechnology allowed researchers at Houston Methodist Research Institute to extend the drug's delivery time so that pain relief lasted all seven days of the study.

Rats that received lidocaine gel through the novel delivery system needed twice the amount of force to elicit a pain response compared with control rats that received no pain medication after the incision, the researchers reported. Using this same technique of measuring the pain response, the investigators reported that the lidocaine gel also was superior to daily treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) alone.

The best study results were seen with combination therapy using lidocaine gel and daily NSAIDs. This combination therapy reportedly showed equivalent effect to daily opioid narcotic treatment by mechanical-force withdrawal testing and superior results by daily scoring of pain-related adaptive behaviors. This finding is important because it shows that the experimental drug delivery system is not inferior to standard opioid treatment of pain, according to Dr. Van Eps...’.

Reference:

  1. http://www.sciencedaily.com/releases/2013/10/131008112535.htm
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