Dr. Wu and others agree opioids are an integral part of postoperative pain management. “I think what’s changed is that prior to the opioid crisis, opioids were one of the first things we’d use to address patients’ postoperative pain. Now we’ve shifted the order, so they’re among the last drugs we choose,” he said.

Dr. Wu noted the lack of data regarding opioid-free anesthesia, citing “Although it might seem intuitive that avoiding opioids is a good thing, don’t forget that if we don’t use opioids, we’re going to have to use other agents, all of which have some side effects.” He added, “And as more and more data come out, it’s becoming clear there are risks associated with some nonopioid agents and techniques as well.”

Read the full article at Pharmacypracticenews.com.

Hip pain and hip tightness can be related to anything from over- or underusing the muscles in the hips, to lower back pain, to more serious conditions like fractures, explained Wu. Sitting all day doesn't help with hip tightness or pain either. "In otherwise healthy individuals — without any underlying medical conditions or surgical history — people who are generally sedentary can experience symptoms of hip tightness among other musculoskeletal complaints throughout the body," noted Wu.

But keeping up with a workout routine and doing exercises for hip pain can help. "People who are more physically active tend to have less disability, live longer and have fewer chronic medical conditions," Wu says. "Many of the consequences of physical inactivity can cause symptoms of joint tightness across the body as well as affect the experience of pain."

Read the full article at Livestrong.com.

"Muscle 'knots,' trigger points, and myofascial pain syndrome are terms that are used to describe the experience of sensitive spots in soft tissue that are commonly associated with injury, or in people with persistent neck/back pain," Wu says.

Wu explains that there is no consistent explanation on how muscle knots are formed and while people can feel relief with massage, acupuncture, ice packs, hot packs and physical activity, treatments sometimes only provide short-term benefits.

"This further highlights the importance of identifying and addressing the factors that may be relevant to that individual's pain experience, rather than just their symptoms," Wu says.

Read the full article at PopSugar.com.

HSS anesthesiologist Christopher L. Wu, MD, who was not involved in the research commented on the findings, saying, “This is very important work, in part because of the contribution of postsurgical opioids to the opioid crisis.” Dr. Wu continued, “There is some thought that surgery is a potential gateway to long-term opioid use, so any way that providers, institutions and health care systems can safely limit prescribing will be of benefit.”

Dr. Wu added that he would like to see future research in the field include a broader range of patients. “The current patient population was largely [white] and male. So certainly, as we go forward, we’ll need to include data to show what opioid consumption averages may be for females, other ethnicities and other procedures.”

This article appeared in the July 2020 print edition.

In 2019, researchers decided to use regional anesthesia in as many hip and knee replacements as possible. Of the 10,485 such procedures performed that year, only 4 percent used general anesthesia. The increased use of regional anesthesia saved the equivalent of nearly 27,000 pounds of coal burned, 2,750 gallons of gas, 60,500 car miles, or 3.1 million smartphones charged, according to the authors. In 2009, there were more than one million hip and knee replacement procedures in the United States. The researchers calculated that if all of these were done under general anesthesia, that would have resulted in 112,000 kg (nearly 247,000 pounds) of desflurane and 9,000 kg (about 20,000 pounds) of nitrous oxide released into the atmosphere. That's equivalent to the greenhouse emissions generated by 3.2 million pounds of coal burned, or 333,000 gallons of gas used, 7,350,000 car miles, or 378 million smartphones charged, they noted.

"Increasing the use of regional anesthesia is potentially good for the climate, improves the quality of care (at least for hip and knee replacements), and may allow individual practitioners to take personal responsibility in the fight against global warming," said Dr. Wu and colleagues. "This certainly is not a complete analysis, as we have not calculated how the manufacture of regional anesthetic agents or the impact of the plastics involved in regional anesthetic kits might affect the earth compared with volatile anesthetics," they noted. The authors also acknowledged that not all surgeries can easily be switched to regional anesthesia.

Read the full article at Consumer.healthday.com.

Additional coverage:

• Medicalxpress.com 
• Reuters Health
• Spectrum News Orlando segment which aired during the evening news hours on June 17, 2020
• Sciencealert.com