April 22, 2024

FDA-Approved Drug Shows Promise in Reducing Opioid Use After Surgery

A recent pilot study conducted by researchers at the Medical University of South Carolina (MUSC) has revealed that an FDA-approved drug may help to decrease pain and reduce the need for opioids after surgery. The study, published in Pain Management, focused on spinal surgery patients who received N-acetylcysteine (NAC) during surgery in addition to standard pain control treatments. The findings showed that these patients reported lower pain scores and requested fewer opioids post-surgery compared to patients given a placebo.

Opioids are commonly prescribed for managing pain after surgery, but their potency and addictive nature raise concerns about patient safety and the potential for long-term opioid use. Therefore, finding alternatives to opioids in managing surgical pain is of great interest to physicians.

Dr. Sylvia Wilson, the Jerry G. Reves Endowed Chair in Anesthesia Research at the Department of Anesthesia and Perioperative Medicine and one of the principal investigators of the study, believes that reducing the need for opioids in pain management is crucial. While completely eliminating the use of opioids may not be feasible, the goal is to minimize the amount of opioids required by patients, said Dr. Wilson.

Dr. Wilson has been working for years to improve pain management and reduce opioid usage after surgical procedures. In collaboration with Dr. Michael Scofield, the Jerry G. Reves Endowed Chair in Basic Science Anesthesiology Research, they explored the potential of NAC—a drug known for its anti-inflammatory properties—in reducing post-surgical pain. NAC is commonly used to treat acetaminophen poisoning, mushroom poisoning, and liver damage. The research team found that NAC had positive effects on the nervous system, particularly in the areas of addiction and pain perception.

The collaborative efforts between physicians and basic scientists have proven to be highly valuable in this study. By bridging the gap between laboratory research and clinical trials, they have made significant advancements in pain management. Dr. Scofield described the project as an elegant synthesis of basic science and clinical research, using laboratory findings to inform clinical practices.

The pilot study focused on spinal surgery patients because they often experience chronic pain prior to surgery and are more likely to consume higher levels of opioids. During surgery, patients received a standard anesthesia regimen along with either NAC or a saline infusion. Data on pain levels and opioid consumption were then collected.

The results showed that patients who received NAC infusion (150 mg/kg) required 19% fewer opioid doses on average than those who received saline. Additionally, the NAC group reported lower pain scores and took longer to request pain medication after surgery compared to the saline group. The researchers were also pleased to discover that the positive effects of NAC lasted longer than expected.

The next step for the research team is to investigate whether the findings can be applied to other surgical procedures. They have initiated a larger trial involving patients undergoing minimally invasive hysterectomies. As more patients are enrolled in the study, the researchers will be able to conduct more comprehensive statistical tests to further understand the effects of NAC on surgery-associated pain. These results will serve as a foundation for future clinical trials involving NAC during surgery.

Dr. Wilson emphasized the importance of conducting large-scale clinical trials in different settings and surgical procedures to determine the safety and efficacy of NAC as an alternative to opioids. The goal is to provide evidence that supports the implementation of NAC in pain management, ensuring both effectiveness and safety in surgical settings.

By exploring alternative treatments and reducing reliance on opioids, researchers and physicians hope to revolutionize pain management after surgery, providing better care and improved patient outcomes. The use of NAC offers a promising solution in the ongoing fight against the opioid crisis.

1. Source: Coherent Market Insights, Public sources, Desk research
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