Surgeons offer narcotic-free surgery, reduce pain and risk of addiction

By Brian Binetti, MD  |  7/25/2018

Opioids are a powerful drug commonly used for pain management, or anesthesia, during surgery. But, they can be dangerous, as they can be addictive for some surgical patients.

Many surgeons at Health Quest Medical Practice are offering an alternative – an opioid-free surgery. That means patients do not have to have anesthesia with narcotics or take them postoperatively at home. Surgeons offer opioid-free, pain management at Northern Dutchess Hospital, Vassar Brothers Medical Center, Putnam Hospital Center and Sharon Hospital in many specialties including colon/rectal, gallbladder, hernia and weight-loss surgeries. Not all surgeons are trained in this approach so it's important to research your options and speak to your doctor.

An opioid-free surgery has two components:

  1. Enhanced Recovery After Surgery (ERAS), involves a set of protocols prior to and after surgery. The steps refer to how to give patients fluids, use alternative pain medications to morphine and Dilaudid, such as Tylenol intravenously, and ensure optimal pre-operative health – including nutrition counseling and physical therapy.
  2. During surgery, a Transverse Abdominis Plane (TAP) block is used to block the nerves that supply sensation to the abdominal wall.  Using a drug called Exparel, which is a long-acting anesthetic. My patients reported numbness for two to three days after surgery.  

Patients can be more comfortable postoperatively even though no narcotics are used.  My opioid free surgical patients report that they do not feel the fatigue side effects of narcotics, so they can walk around after surgery. Some of my opioid-free, weight-loss surgical patients were up walking within hours of their procedure which can help prevent certain postoperative complications like  deep vein thrombosis.

Narcotics can cause constipation. Without them, some patients can experience proper bowel function much sooner postoperatively, a requirement for going home after many surgeries. Patients can also sleep better. Rest is important for the healing process.

Lastly, patients don't need to take opioids home with them after surgery, reducing the addiction risk to themselves and others.

Patients also need to be their own advocates. Read more about opioid-free surgery at goopioidfree.com.

Dr. Binetti is a general surgeon with Health Quest Medical Practice in Rhinebeck and Kingston, with privileges at Northern Dutchess Hospital. He is also the hospital's bariatric surgery medical director. For more information, reach his office at 845-871-4275 (TTY: 800-421-1220).