If you need to have surgery to repair a hernia, you may experience better surgical outcomes if you avoid taking opioids prior to your operation than those who do.
According to presenters at the America’s Hernia Society 2016 meeting, avoiding opioids for abdominal wall repair (AWR) prior to surgery has been linked to two significant improvements in post-surgical recovery. Those who avoided AWR opioids prior to surgery:
- Had a decreased need for opioids while in the hospital recovering from surgery; and
- Had a shorter post-op stay in the hospital, on average.
“We were beginning to see the impact of opioid use on our patient group, even preoperatively,” said Dr. Bruce Ramshaw, professor and chair of surgery at the University of Tennessee Graduate School of Medicine. “We wanted to know the impact of opioid use on patients who have been using them – for back pain, hernia pain or some other problem – prior to surgery. There is growing evidence that the opioids we use for postoperative pain management lead to patients becoming addicted or using opioids long term.
Hernia Surgery and Opioids
For their analysis, researchers conducted a retrospective study of 102 patients who underwent surgery to repair a hernia in their abdominal wall. Of those patients, 47 people were already taking opioids prior to surgery, and researchers also tracked other factors like patient demographics, information on previous abdominal surgeries, and if the patient smoked.
After looking at the data, researchers found that the total morphine equivalents during hospitalization was significantly higher for patients who used opioids prior to hernia than those who didn’t (340.24 vs. 165.59). People who avoided opioids before hernia surgery also had a slightly shorter length of stay on the surgery center after the operation.
“Opioid use or overuse is a hot topic right now, and recognition that patients who are already using opioids may constitute a higher-risk population for AWR that allows us to identify another area for risk modification,” said Dr. Archana Ramaswamy, a surgeon at the Minneapolis VA and associate professor at the University of Minnesota, Minneapolis. “This next step may be to see if multimodal opioid-sparing therapy pre- and postoperatively, allows these patients to have similar outcomes to the opioid-naive ones.”
Now obviously some people are in significant pain after a hernia develops, but the study results certainly are interesting. It appears that doctors should really begin to take a closer look to see if patients truly need opioids prior to hernia surgery, because if they can avoid it, they may experience better surgical outcomes.
