2 8 S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E J U N E 2 0 1 5
on opioids when it comes to
acute pain management.
• Do opioids have any value?
Opioids are great for nocicep-
tive pain, but post-op pain is a
mixed bag. We make the mis-
take of thinking of it as noci-
ceptive pain alone. For exam-
ple, many patients have burn-
ing pain, which is characteris-
tic of neuropathic signaling.
Antineuropathic agents like
gabapentoids are extremely
effective in that situation. In
fact, they have analgesic prop-
erties that reduce the need for
opioids, regardless.
• Other alternatives. In terms of
both safety and effectiveness,
both acetaminophen and
selective or non-selective
NSAIDs are better post-op
choices. Pain is multifactori-
al. In addition to being noci-
ceptive, it's visceral, it's
inflammatory, it's neuropathic
and it's spasmodic. We need
to target all the relevant fac-
tors in any given case, and
