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Doctors Find Two New Ways to Treat Postoperative Pain

Update Date: Oct 08, 2013 11:13 AM EDT
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For people undergoing invasive surgery, the journey towards recovery can be long and arduous. Even though the degree of the surgical procedure might vary greatly, all patients experience postoperative pain. This kind of pain is usually treated with narcotics and will subside after a certain amount of time. Even though painkillers are effective, there is a risk of addiction, which is why reducing the need for painkillers is important. Now, doctors stated that they have found two new ways of lowering postoperative pain without the need for narcotic pain relievers.

"A growing body of scientific evidence shows that narcotics may not be the best way to control pain," Viraj A. Master, MD, Ph.D, FACS, associate professor of urology at Emory University School of Medicine, said. "We now know that it is more effective to use combination treatments that reduce the amount of narcotics needed."

These two new approaches to treating postoperative pain come from two studies that were presented at the 2013 Clinical Congress of the American College of Surgeons. In the first study, called the ice pack study that was headed by Master, the research team discovered that cryotherapy is a safe and effective form of treatment for pain reduction. Cryotherapy involves placing an ice pack on the surgical wound to reduce pain. The researchers compared the effects of cryotherapy on 27 patients. The results were compared to 28 patients that did not receive any ice therapy. All of the patients in the sample set had an open, large-incision abdominal operation.

The group of patients on cryotherapy was allowed to use the ice packs on their own for at least 24 hours. They were also given the option of taking opioids. The other group only received opioids. The patients were asked to rate their pain twice a day along a scale from zero to 100, 100 being severe pain. The researchers reported that on average, the group on ice therapy reported 50 percent less pain on the first and third days post operation. On the first day post-surgery, the patients on ice therapy used 22.5 percent less opioid medications than the other group.

"An ice pack is safe and inexpensive, gives the patient a sense of empowerment because it is self-care, and doesn't require high-tech devices," Master said.

In the second study, headed by Jeffrey L. Van Eps, MD, a research associate at the Houston Methodist Research Institute and general surgery resident at Houston Methodist Hospital, the team created a new treatment for postoperative pain. The team developed a hydrogel with lidocaine. The gel contains a biodegradable polymer titled polylactic-co-glycolic acid (PLGA), which is FDA-approved (Food and Drug Administration) for drug delivery.

"Nanotechnology with PLGA makes an ideal drug delivery system because we can tailor the nanoparticles to allow prolonged delivery," Can Eps said.

The team tested this new form of treatment, which is administered via injection, on mouse models. They found that mice given the injection experienced less pain compared to the control group of mice. The researchers reported that the best results in pain reduction occurred when they mixed the hydrogel with nonsteroidal anti-inflammatory drugs (NSAIDs). The research team plans on testing this form of treatment in larger animals before they can move on to human trials.  

Both of these studies' findings could greatly help with pain reduction for surgical patients. These approaches would also reduce people's dependence on pain relievers, which could lower the risk of prescription drug abuse.

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