Providence-based Ortho Rhode Island surgeon Michael Bradley, MD, and anesthesiologist Henry Cabrera, MD, are rolling out a new pathway to curb opioid dependency at South County Health Orthopedics Center in Washington County, R.I.
Dr. Bradley and Dr. Cabrera both stress the idea of reducing and managing a patient's pain over eliminating a patient's pain.
Here are five highlights:
1. Dr. Bradley describes the processes as a four-part pathway or a multi-modal attack on pain.
2. Green Line Apothecary, a full-service pharmacy, is the first pathway stop. Three days prior to surgery, patients go to the pharmacy to pick up a blister pack of pre-ordered medication.
Each pack contains acetaminophen, meloxicam (a nonsteroidal anti-inflammatory drug), gabapentin (a neuropathic pain pill), omperazole (a proton pump inhibitor) and tranexamic acid (a blood clotting medication).
3. Next patients enter the intra-operative step. Instead of using a general anesthetic, the physicians use a spinal anesthetic to decrease the number of narcotics a patient needs post-surgery.
4. The post-operative stage addresses the various drugs patients are given between the time they are discharged from the recovery room and discharged from the hospital. Dr. Bradley recommends controlling a patient's pain with non-narcotic options first to reduce nausea and other adverse side effects.
5. Dr. Bradley and Dr. Cabrera recently added a fourth step for post-discharge. This address a patient's comfort from when they leave the hospital to around a week later.
Editor's note: This article was updated March 23 to clarify Green Line Apothecary's blister packs do not contain narcotics.