• Posted March 8, 2024

You Can Safely Avoid Addictive Long-Acting Opioids After Knee Replacement

It's well known that long-acting opioid meds raise the odds for addiction in users -- including folks dealing with pain after an orthopedic surgery.

Now, new research suggests that patients fare just as well if doctors prescribe less risky immediate-release opioids following a knee replacement surgery.

Pain management was equal to that seen in patients on long-acting opioids, researchers report, and patients even had fewer bouts of medication-linked nausea.

"If you can move from long-acting to immediate-release opioids without increased pain or other adverse effects, that's a win," said study co-author Judith Barberio, a clinical associate professor with Rutgers School of Nursing in New Jersey. "This quality improvement project suggests it's possible to do that when recovering from a total knee replacement."

Barberio and her colleagues noted that U.S. surgeons replace about 790,000 bum knees each year. Experts have long known that the painful recovery period after joint surgery can be hazardous in terms of developing an opioid addiction.

In the study, the research team took advantage of a planned switch in post-op protocol by one knee replacement surgeon: Switching patients from extended- to immediate-release opioids for pain.

The study tracked outcomes for 36 patients who underwent surgeries before the change to those of 34 patients who got immediate-release opioids after the change.

The result: No difference in patients' pain scores, regardless of which type of opioid they received.

And, as an added bonus, patients who got immediate-release opioids were nauseous less often and needed fewer anti-nausea pills. Nausea and vomiting are a common side effect of opioid painkillers.

That was no small thing, noted senior study author Jill Cox, a clinical professor at Rutgers.

"Feeling nausea to the point that you need medical intervention can be unpleasant and may increase your pain and impact your rehabilitation," she explained in a Rutgers news release.

Folks who got the short-acting opioids also tended to be discharged to their homes sooner, while those on long-acting opioids tended to require time in residential rehab before heading home, the study found.

The reason behind that isn't clear, although the team theorized that extended-release opioids might act on the brain to hamper cognitive function and balance. That would make a safe return to the activities of daily living tougher, they said.

The study was published recently in the journal Pain Management Nursing.

More information

Find out more about recovery from knee replacement surgery at the Cleveland Clinic.

SOURCE: Rutgers University, news release, March 8, 2024