Our Summary

This research paper discusses the problem of doctors and dentists prescribing too many opioids, a type of strong painkiller, even for minor surgeries. Despite a decrease in the national prescription of opioids, these professionals have not changed their habits. The paper suggests that the guidelines for prescribing opioids are not effective due to the anchoring heuristic, a psychological concept where people rely too heavily on the first piece of information they receive. The paper suggests that doctors should take the lead in reducing the use of opioids and should aim for performing minor surgeries without the use of these painkillers whenever possible.

FAQs

  1. What does the article suggest about surgeons’ opioid prescribing habits?
  2. What does the article mean by “anchoring heuristic” in relation to opioid guidelines?
  3. What is the proposed goal for minimally invasive surgery according to the article?

Doctor’s Tip

Tip: One important tip that a doctor might give a patient about minimally invasive surgery is to inquire about pain management options that do not involve opioids. It is important to advocate for yourself and discuss alternative pain management strategies with your healthcare provider to minimize the risk of opioid dependence or misuse. Additionally, following post-operative care instructions carefully and attending follow-up appointments can help ensure a smooth recovery process after minimally invasive surgery.

Suitable For

Patients who are recommended for minimally invasive surgery typically include those who have conditions that can be treated effectively with less invasive procedures, such as:

  • Patients with hernias
  • Patients with gallbladder issues
  • Patients with joint problems (e.g. knee or hip replacements)
  • Patients with spine conditions (e.g. herniated discs)
  • Patients with heart conditions (e.g. coronary artery disease)
  • Patients with certain types of cancer (e.g. prostate cancer, thyroid cancer)

Minimally invasive surgery is often preferred for these patients because it typically results in less pain, shorter recovery times, and lower risk of complications compared to traditional open surgeries. Additionally, minimally invasive surgery can often be performed on an outpatient basis, allowing patients to return home the same day.

Timeline

Before minimally invasive surgery:

  1. Consultation: The patient meets with their surgeon to discuss their condition, treatment options, and the possibility of minimally invasive surgery.

  2. Pre-operative preparation: The patient undergoes pre-operative tests, receives instructions on how to prepare for surgery, and may need to stop taking certain medications.

  3. Surgery day: The patient arrives at the hospital or surgical center, goes through pre-operative procedures, and is taken to the operating room for the minimally invasive surgery.

  4. Recovery: After the surgery, the patient is monitored in the recovery room before being moved to a hospital room or discharged home.

After minimally invasive surgery:

  1. Pain management: The patient may experience some pain or discomfort after surgery and is prescribed pain medication, often opioids, to manage the pain.

  2. Recovery at home: The patient follows post-operative instructions, such as rest, physical therapy, and wound care, to aid in their recovery.

  3. Follow-up appointments: The patient sees their surgeon for follow-up appointments to monitor their healing progress and address any concerns or complications.

  4. Return to normal activities: As the patient heals, they gradually return to their normal activities and may require less pain medication.

Overall, the goal of minimally invasive surgery is to provide patients with a quicker recovery, less pain, and a lower risk of complications compared to traditional open surgery. Efforts should be made to reduce opioid prescribing and promote non-opioid pain management strategies to improve patient outcomes.

What to Ask Your Doctor

  1. What are the potential risks and benefits of minimally invasive surgery compared to traditional surgery?
  2. How long is the recovery time expected to be after minimally invasive surgery?
  3. Will I need to take opioid pain medication after the surgery, and if so, for how long?
  4. Are there alternative pain management options available that do not involve opioids?
  5. What measures will be taken to minimize the risk of opioid dependence or addiction following surgery?
  6. How experienced are you in performing minimally invasive surgeries, and what is your success rate with this procedure?
  7. What is the expected outcome of the surgery, and what are the potential complications to watch out for?
  8. How soon can I return to normal activities and work after minimally invasive surgery?
  9. Are there any lifestyle changes or precautions I should take before or after the surgery to optimize the results?
  10. Can you provide me with resources or information on opioid-sparing techniques and pain management strategies for post-surgical recovery?

Reference

Authors: Davies B, Brummett CM. Journal: Ann Surg. 2020 Jan;271(1):37-38. doi: 10.1097/SLA.0000000000003379. PMID: 31188218