Lasting Effects of Post Surgery Pain Care

Opioids and NSAIDs taken after minor surgery linked to use one year later

(RxWiki News) Pain medications, like opioid painkillers and NSAIDs, are often prescribed after minor surgery. The short-term benefits of good pain management are well-known. Short-term use may, however, be linked to long-term use.

Researchers found that people who were taking opioids or non-steroidal anti-inflammatory drugs (NSAIDs) within the first week after minor surgery were much more likely to be taking those same medications one year later, well after they had recovered from the surgery. 

"Discuss all pain management options with your doctor"

Researchers at St. Michael’s Hospital in Toronto, led by Chaim Bell, MD, PhD, looked at patient records to see the short-term and long-term use of both opioids and NSAIDs in patients after minor surgery.  Patients who began taking opioids during the first week after surgery were 44% more likely to be taking opioids one year later compared to patients that were not prescribed opioids after surgery.

Similarly, patients who started taking NSAIDs after surgery were 4 times more likely to be taking NSAIDs one year later than patients who did not start taking NSAIDs just after surgery. 

The researchers compiled prescription information about patients for the first seven days after surgery and again at one year after surgery. Patients in this study were elderly (66+ years old) and were admitted for brief-stay surgeries like varicose vein stripping, cataract surgery, and minimally invasive procedures (such as laproscopic and intraurethral procedures). All the patients included in the analysis were taking either an opioid or prescription NSAID for the first time when they were prescribed it post-surgery.  The risks reported in this study may be different for other age groups and for those with a history of taking opioids or NSAIDs.

This is new evidence that taking pain medications after surgery appears to increase use of such medications later. Long-term use of these medications increases risk of adverse effects. The researchers note that prescriptions of these medications to be taken as needed eliminates some of the doctor control over pain management, which could be a worrisome factor.

The researchers advise that increased risk of long-term use of opioids and NSAIDs could be a factor in decisions about short-term pain management. They recommend that doctors consider possible long-term risks with short-term recovery needs by considering alternative therapies or more controlled pain management.

This study is reported March 12, 2012 issue of the Archives of Internal Medicine.

Some of the authors in this study reported relationships with Hoffman La Roche, GlaxoSmithKline, Pfizer, Novartis, Eli Lilly, Novo Nordisk, AstraZeneca, and Bristol-Myers Squibb.

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Review Date: 
March 13, 2012