More secure drugs reduce need for narcotics
According to the American Society of Anesthesiologists,
acetaminophen (the active component in Tylenol) in the form of
injection and COX-2 inhibitors hold promise as secure and
effective tools of surgical pain control. Scientists from Yale
University, New Haven, Conn., claim that both substances
considerably reduce morphine intake in patients recovering from
surgery.
An anesthesiologist Raymond Sinatra says: "Lowering morphine
consumption reduces postsurgical complications and helps
patients recover quicker. That translates into shorter hospital
stays, healthier patients, and reduced health care costs."
On the one hand morphine relieves pain, but on the other hand it
may cause unwanted side effects such as nausea, vomiting,
constipation, drowsiness, and a slowdown in breathing. That is
why anesthesiology research concentrates on looking for
alternative drugs that can reduce or eliminate the need for
morphine.
It can be achieved thanks to a new soluble form of acetaminophen
delivered by a catheter into a vein. This drug reduced morphine
intake by more than 30% in patients studied following major hip
or knee surgery who were able to give themselves the narcotic by
means of a patient-controlled analgesia pump. It is expected
that the medication will be approved soon by U.S. Food and Drug
Administration.
Sinatra says that the injectable form of acetaminophen reaches
the central nervous system sooner and in a higher concentration
than in standard tablet form. This is how it enhances the drug's
analgesic power. It is a wonderful method of dealing with pain
in orthopedic patients (suitable healing following many types of
orthopedic surgeries relies on an inflammatory process helping
build new bone). Injectable acetaminophen is not an
anti-inflammatory drug and this is why it does not interfere
with this healing process.
A second Yale research discovered the safety and effectiveness
of a COX-2 inhibitor, rofecoxib, as a surgical pain reliever.
The study zeroed in on the medication's ability to decrease pain
and ameliorate the ability of patients to cough after abdominal
surgery as well as its role in diminishing morphine intake.
COX-2 inhibitors act by selectively switching off one of the
cylooxygenase (COX) enzymes that is in charge of the production
of prostaglandins.
Surgical cut in the abdominal area usually make a 30-40%
decrease in normal breathing patterns, especially in patients
receiving morphine after surgery. The patients who got a single
50-mg dose of rofecoxib syrup before surgery had just a 15%
decline in lung function after surgery, compared to 35-40% for
the placebo group. What's more, the rofecoxib group consumed 44%
less morphine than the control group within the first 24 hours
after surgery.
According to Sinatra, "While we won't eliminate the need for
morphine in the near future, administration of safe non-narcotic
analgesics can minimize its use while at the same time improving
Pain relief".