Better pre-op meds for less post-op pain & nausea

Better pre-op meds for less post-op pain & nausea

Posted on November 16, 2010

Ask anybody what they worry about when they are thinking of having surgery, and I’m willing to bet that answers like “I’m worried that I’ll be in pain or be nauseated” are near the top of the list.

What if I told you that, with improved medications prior to surgery, we could make this a lot better than traditional methods? Interested? You betcha!

Anesthesiologists and surgeons have been doing a lot of research on this area, to determine the best types of drugs to reduce post-op pain. And the answer isn’t always “just give more”, because the side effects of nausea, vomiting, sedation and respiratory depression from opioids like morphine, fentanyl or demerol can start to become problematic. It turns out that the combination of several different strategies works best. Technically, this is called “multi-modality treatment for postoperative analgesia”. (Impress your friends with that phrase!)

Interestingly, a medication used for years as an anti-epilepsy agent, called gabapentin, is a real winner for ambulatory surgery patients. One dose given pre-operatively has been proven in multiple studies to reduce post-op pain, reduce the need for opiate medications post-operatively, and reduce the incidence of nausea and vomiting after surgery.

Also, a non-steroidal anti-inflammatory medicine (NSAID) called diclofenac has be proven to be helpful in reducing post-op pain and swelling. Unlike many other NSAID’s, this one doesn’t have a significant effect on platelet function, so it’s OK to take at the time of surgery.

We’re in the process of switching over to this improved pre-op combo. By reducing post-op pain, patients will be obviously have an easier time with their recovery. By reducing the need for strong narcotics, they’ll have fewer side effects.

Should be a winner for everyone!


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