Listen to “AT A TIME WHEN DRUG OVERDOSE DEATHS ARE CLIMBING A NEW TREATMENT FOR POSTOPERATIVE PAIN MAY HELP REDUCE THE NEED FOR OPIOIDS AFTER SURGERY” on Spreaker.
At a time when deaths from drug overdoses are on the rise, there’s a new effort to help keep people from getting hooked on prescription opioids in the first place.
The CDC released data reporting that more than 93,000 people died from drug overdoses in 2020, which is an almost 30 percent increase from 2019.
[In advance of Pain Awareness Month in September] Here now to talk about the role non-opioid options can play in the surgical setting to help prevent opioid addiction before it starts, is orthopedic surgeon from Orthopaedic Associates in Houston, Texas Dr. Alan Rechter (“Rek-ter”).
As we are approaching Pain Awareness Month in September, it is a time to highlight the issues of postoperative pain and postoperative pain management in the United States. Recent data shows that 67% of patients filled an opioid prescription between 30 days before through 14 days after surgery. In the past, postoperative pain management has been a one-size-fits all approach and there is an urgent need for it to be more individualized.
While patients routinely are searching for a safe and effective way to manage the pain they experience following surgery, many tell doctors they want to avoid the adverse effects that are commonly experienced by those receiving opioids to reduce their pain. The most common adverse effects are dizziness, nausea and constipation. But even more than that, patients want to avoid any risk of misuse and addiction.
Now there’s been a new development; what some surgeons are calling a “game-changer” for postoperative pain. The FDA recently approved a treatment that works on both inflammation and pain at the surgical site for up to 3 days for those who undergo bunion surgery, hernia repair and total knee replacement surgeries. Clinical trials have shown that this new treatment reduces the need for and can eliminate in many patients, potentially addictive opioids. The safety and efficacy of this new treatment has not been established in highly vascular surgeries, such as intrathoracic, large multilevel spinal, and head and neck procedures. The new treatment also contains an NSAID (non-steroidal anti-inflammatory drug), a type of medicine which:
can increase the risk of a heart attack or stroke that can lead to death. This risk increases with higher doses and longer use of an NSAID.
cannot be used during heart bypass surgery.
can increase the risk of gastrointestinal bleeding, ulcers, and tears.
Dr. Alan Rechter, an orthopedic surgeon, will be available to discuss the newest method of effectively managing postoperative pain. He will explain why this latest development is such an important step in helping patients who are undergoing a variety of procedures.
Interview Courtesy: Heron Therapeutics
NCHS, National Vital Statistics System. Estimates for 2020 are based on provisional data. Estimates for 2015-2019 are based on final data (available from: https://www.cdc.gov/nchs/nvss/mortality_public_use_data.htm (https://www.cdc.gov/nchs/nvss/mortality_public_use_data.htm)).
Santosa KB, Hu HM, Brummett CM, et al. New Persistent Opioid Use Among Older Patients Following Surgery: A Medicare Claims Analysis. Surgery. 2020;167(4):732-742. doi:10.1016/j.surg.2019.04.016
U.S. Food & Drug Administration. Data presented at June 11-12, 2019 Joint Meeting of the Drug Safety and Risk Management (DSaRM) Advisory Committee and Meeting of the Anesthetic and Analgesic Drug Products Advisory Committee (AADPAC).
ZYNRELEF [Package Insert]. San Diego, CA: Heron Therapeutics Inc.; 2021.
Viscusi E, Gimbel JS, Pollack RA, Hu J, Lee G-C. HTX-011 reduced pain intensity and opioid consumption versus bupivacaine HCl in bunionectomy: phase III results from the randomized EPOCH 1 study. Reg Anesth Pain Med. 2019;44(7):700-706. doi:10.1136/rapm-2019-100531.
Viscusi E, Minkowitz H, Winkle P, Ramamoorthy S, Hu J, Singla N. HTX-011 reduced pain intensity and opioid consumption versus bupivacaine HCl in herniorrhaphy: results from the phase 3 EPOCH 2 study. Hernia. 2019;23(6):1071-1080. doi:10.1007/s10029-019-02023-6.
BIO-Alan Rechter, M.D.
Orthopedic Surgeon at Orthopaedic Associates
Dr. Alan Rechter is a board-certified orthopedic surgeon and has practiced medicine in Houston since 1995. He joined Orthopaedic Associates in 1999 and has staff privileges at Methodist West & Houston Orthopedic & Spine Hospital in Bellaire. He is a former Clinical Assistant Professor of Orthopedics at the University of Texas Medical School.
Throughout his career, he received numerous awards. He was recognized by Merck Pharmaceuticals as one of the top ranked medical school graduates during his graduating year. He received a prestigious AO International Fellowship in Germany, which affords focused training in the arts of trauma, hand and joint reconstructive surgery.
Dr. Rechter received his Bachelor’s degree from the University of South Florida and his medical degree from Creighton University School of Medicine in Omaha, NE. Dr. Rechter completed his training in orthopedic surgery at the University of Texas in Houston after being Chief Resident for the 1998-1999 academic year.
ZYNRELEF is approved for use in adults to reduce pain for up to 3 days after removal of bunions, groin hernia repair, and total knee replacement. ZYNRELEF is applied into the wound at the time of surgery.
Important Safety Information
ZYNRELEF contains an NSAID (non-steroidal anti-inflammatory drug), a type of medicine which:
• can increase the risk of a heart attack or stroke that can lead to death. This risk increases with higher doses and longer use of an NSAID.
• cannot be used during heart bypass surgery.
• can increase the risk of gastrointestinal bleeding, ulcers, and tears.
ZYNRELEF should also not be used:
• if you are allergic to any components of ZYNRELEF, aspirin or other NSAIDs (such as ibuprofen or naproxen), or have had an asthma attack, hives, or other allergic reaction after taking any of these medicines.
• as a paracervical block, during childbirth.
The most common side effects of ZYNRELEF are constipation, vomiting, and headache.
The medicines in ZYNRELEF (a local anesthetic and an NSAID) can affect the nervous and cardiovascular system; may cause liver or kidney problems; may reduce the effects of some blood pressure medicines; should be avoided if you have severe heart failure; may cause a rare blood disorder, or life-threatening skin or allergic reactions; may harm your unborn baby if received at 20 weeks of pregnancy or later; and may cause low red blood cells (anemia).
Tell your healthcare provider about all your medical conditions and about all the medicines you take including prescription or over-the-counter medicines, vitamins, or herbal supplements to discuss if ZYNRELEF is right for you
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