Opioids, also known as narcotics, have historically been the mainstay of pain control after surgery. Examples include Vicodin (Norco), and Percocet (Oxycodone). While these medications help with pain, they have significant side effects including addiction (within 5 to 7 days of use), constipation, and fatigue. In our practice 30% of patients do not take a single narcotic after their shoulder surgery and among those who do, most stop taking them within a couple of days. In fact, Dr. Denard only prescribes 15 narcotic pills for after surgery.
How is this possible? We use a multimodal approach to limit pain. They key is the address pain from multiple facets. Our protocol consists of:
- Limited surgical time
The longer surgery goes on the higher inflammation levels become and the more pain increases. Dr. Denard has performed over 8000 surgeries. With this level of experience, surgical efficiency is improved, and surgical time thus decreases. This is highly surgeon dependent!
- Education
Understanding the risks of narcotics and not taking them unless needed helps patients avoid the trap of taking them for “prevention.”
- A Nerve Block
Most patients have an interscalene nerve block with numbs the nerves that affect the shoulder. This last for 12-24 hours after surgery
- ICE
A simple but highly effective method for reducing pain! Cold compression units are highly beneficial and can help with sleep as well
- Tylenol
Tylenol or acetaminophen blocks prostaglandin synthesis and is processed by the Liver
- Ibuprofen
Ibuprofen or Advil is a COX-1 and 2 inhibitor that is processed by the liver
- Gabapentin
Gabapentin or Neurontin is a nerve pain medication that can be used for a short duration as well to limit pain.
Dr. Patrick Denard has been voted one of the top 20 Shoulder Surgeons in North America, and has been ranked in the top of 1% of researchers for Shoulder. Dr. Denard is committed to providing the highest level of orthopedic care to his patients, not only from a surgical standpoint, but also by considering the overall picture including avoidance of narcotics, and optimizing nutrition and rehabilitation. With this approach, over 95% of his patients are able to go the same day of surgery. Many patients travel to the Oregon Shoulder Institute to seek care for their shoulder. To request a shoulder opinion follow the link below to schedule a consult:
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