reasonable expectations for post-op recovery — surgery will hurt, at
least a little — and emphasize the importance of using multimodal,
opioid-sparing pain management techniques. For example, combining
200 mg of ibuprofen and 500 mg acetaminophen is at least as effective,
if not more effective, than popping 2 Percocet to relieve post-op pain.
Patients should be sent home with customized discharge prescrip-
tions based on their specific pain management needs, says Dr. Gulur.
Patients who undergo surgery at Duke Health typically receive
NSAIDs and acetaminophen for comfort and a limited number of opi-
oids for managing breakthrough pain.
Schedule follow-up appointments with patients 10 to 14 days after
surgery and adjust pain medication prescriptions as needed. Also
make sure your team is available at any time if patients have ques-
tions about their pain levels, suggests Dr. Gulur.
She says that availability limits the number of calls patients make to sur-
geons and primary care physicians, who are often unfamiliar with treating
post-op pain and end up sending them to emergency rooms for care that
could have been avoided with a quick call to one of your providers.
Proof positive
Patients at Duke Health are now discharged with personalized pre-
scriptions. The result, says Dr. Gulur, has been a significant reduction
in the amount of opioids used to control post-op pain.
"But it's not just about writing fewer scripts," she points out. "We
also need to ensure patients are doing well."
They are. Rates of medication-related harm have decreased while
patient satisfaction scores have improved.
Says Dr. Gulur, "We've been prescribing fewer opioids and our
patients are happier because we're treating them with personalized
care plans that address their specific needs."
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