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Pain management pre-surgical and post surgical

Started by Skylar on 05/04/2011 1:58am

How do most doctors handle chronic pain patients' pain meds before surgery and post surgery? Are there two schools of thought regarding no narcotics before surgery versus your usual dose of narcotics before surgery.

Considering fusion surgery for stenosis. Been on oxycontin 80mg a day for 10 years. One doctor says take usual pain meds up until day of surgery and 2nd opinion doc says I would have to do a 3 week medical detox and be off all oxycontin prior to surgery. The medical detox is not for addiction but to allow the nerves and pain receptors to reset. The doctor also said that higher doses of oxycontin cause back pain. I don't know if that is true or not.

The doctor that requires you to do a medical detox and be off of oxycontin prior to surgery says that if you don't come off of the drug and do surgery, then you will be in excruciating pain and your normal dose of meds will not cover the pain.

I understand that any new pain from surgery would not be covered by usual chronic pain dose because I am acclimated at this level. But I am just wondering if there are two different ways to accomplish the same thing.

Is this a reasonable approach? Take usual chronic pain dose up to day of surgery, take a temporary post surgical dose as prescirbed by pain doc until post surgical pain is bearable, taper down to usual chronic pain dose then either taper down as low as you can go or do a medical detox to come off completely.

I cannot go beyond 1 hour past my usual chronic pain dose without incurring severe cutting, burning, and other pain. Neurontin for nerve pain alone doesn't cover it.

I recently had hemmhroid sugery and my pain doctor said my usual chronic pain meds would not cover surgical pain. I took my usual dose up until surgery. My doctor prescribed a temporary post surgical dose, then I tapered back to my usual dose with no issues.

I do understand that if you are on a lower dose or no meds at all then the pain meds after a fusion or any surgery will work better. That's just logical. I am just wondering if it is absolutely neccessary to come off all meds completely with a medical detox in order to do the fusion.

Thank you

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When I had my surgery, I could take pain meds up to the day before surgery. As long as none of your meds cause thinning of the blood, I was ok t take them. Only pill i had to take the day of surgery was blood pressure and xanax. The surgeon monitered me for 3 months after, and he supplied the scripts for the pain meds. Now I'm back on my regular meds given by my regular docs.