Reducing reliance on opioids for post-surgery pain

Trial to evaluate medication to help patients ambulate faster and get home sooner after surgery By Brian Sodoma

Opioids have long been used for pain management after surgery. But as we know, these powerful drugs can be addictive. One study published by the International Anesthesia Research Society found that Dr. Marc Jacofsky 7.7 percent of surgery patients who had not taken opioids in the past were more likely to still use them one year after their operation.

Today, the MORE Foundation is partnering with The CORE Institute to conduct a study that hopefully improves that statistic. Together, the organizations will conduct a prospective randomized controlled trial that could help to minimize the need for opioids after surgeries and offer the same pain relief needed to get patients back in motion faster.

ABOUT THE STUDY

The MORE Foundation is currently enrolling up to 150 orthopedic surgery patients in a trial using the FDA-approved drug, DSUVIA, or sufentanil. It’s a pain medication placed under the tongue at pre and post-operative stages to test if less opioid medication is needed throughout the surgery process and on through to discharge. It’s the first trial of its kind involving orthopedic surgery participants.

The FDA-approved medication was tried on a smaller sample population at The CORE Institute Specialty Hospital earlier this year; initial results were positive. Marc Jacofsky, Ph.D., Executive Director of Research and Education for the MORE Foundation, heard about the preliminary analysis and saw the opportunity to further test the drug with the gold standard of research, a randomized controlled trial.

Under the MORE Foundation’s grant-funded study, half the patients will use the standard opioid regimen and the other half the DSUVIA regimen. The CORE Institute teams will focus on patient care while MORE Foundation researchers monitor results. A medical safety board will be created to monitor and address any safety concerns.

POTENTIALLY A NATIONAL STANDARD

Joshua Hauns, Pharm.D, a pharmacist and the Senior Clinical Director at The CORE Institute Specialty Hospital, partnered with The CORE Institute’s hip and knee surgeon, Dr. John Thompson, to test the DSUVIA regimen earlier this year. “We’re trying to find that sweet spot between what relieves pain but doesn’t knock you out,” Hauns emphasized. “Ultimately, this all comes

down to the question of ‘does this medication allow the patient to ambulate faster and go home sooner?’” So far, that answer could be “yes.” Dr. Thompson said patient pain scores were low and cognition was good. He saw “prolonged pain relief over 24 to 48 hours, which ultimately decreased the patient’s dependence on other narcotics.” Some even started ambulating in as little as an hour after surgery, Hauns noted. “Both stressed that these early findings are preliminary and much more study and analysis of the data will be required to understand the true effectiveness and potential role for this medication.” The partnership between Dr. John Thompson The CORE Institute, its specialty hospital, and the MORE Foundation is an interdisciplinary collaboration that can benefit all orthopedic patients around the nation. “These efforts can help patients beyond The CORE Institute. If we’re able to demonstrate this medication reduces overall opioid use, it could become a national standard.” Dr. Jacofsky added. “This study shows how effective collaboration between clinicians, hospitals and researchers is critical to achieving our mission—to continually define the standard of musculoskeletal care.” Joshua Hauns, Pharm.D

To learn more, visit more-foundation.org.