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Spinal surgery is painful, but fewer addictive opioid painkillers are needed now to help kids and teens manage it, a new study finds.
A research team from Michigan Medicine found that scoliosis patients undergoing spinal fusion can be prescribed fewer opioids and still get adequate pain control after surgery.
"Spinal fusion is arguably one of the most painful procedures we perform in pediatric orthopaedics, but our findings show we can provide excellent pain control by employing multimodal pain management techniques and preoperative education,"said senior study author Dr. Ying Li, an orthopedic surgeon at C.S. Mott Children's Hospital in Ann Arbor.
The research included 72 teens who underwent spinal fusion at University of Michigan Health. Each was prescribed 30 doses of oxycodone, as well as standard non-opioid medications after their procedure.
Before surgery, 49 patients and their caregivers received an education on the risks of opioids and the importance of non-opioid pain management. The other 35 received no preoperative education.
Even though both groups received the same number of opioids at discharge, 23% of those who received no preoperative education asked for refill -- compared to just 6% of those in the education group.
Compared to 77 teens who previously had the surgery without standard discharge prescription guidelines, patients in the study used less oxycodone and for fewer days.
On average, the previous patients used an average 29 doses when receiving a larger quantity of oxycodone. Knowing that, doctors prescribed these new patients 30 doses. But they only took about 16, while also reporting very low pain scores.
"Our results show that when we prescribe patients less narcotics, they will take fewer narcotics, so prescription quantity is incredibly important after a procedure like this,"Li said. "We want to avoid situations where someone is overprescribed opioids and takes too many or leftover opioids are diverted to others."
He said preoperative education and use of a multi-pronged approach to pain management are key to reducing harm and preventing drug disorders and overdose.
The findings were recently published in the Journal of Pediatric Orthopaedics.
More information
The National Library of Medicine has more on scoliosis surgery for children.
SOURCE: Michigan Medicine, news release, Aug. 3, 2022