While women proactively plan for surgeries, they often miss a key question: how can pain management improve their recovery? Non-opioid options as part of a multimodal protocol allow for patients to have a shorter hospital stay and overall enhanced recovery experience while reducing the need for opioids. These options are now available for numerous women’s health surgeries including hysterectomies, breast reconstruction and planned/unplanned C-sections. And since C-sections are the most common surgery performed in the country, it is important that soon to be mothers are aware of their options.

Dr. Uma Shastri is an anesthesiologist at Northside Hospital in Atlanta, Georgia. She has a passion for improving patient outcomes by utilizing regional anesthesia techniques and providing effective alternative options for patients undergoing surgery. She is here to speak with us about non-opioid options for women’s health procedures, and the importance of advocating for minimizing opioid use in the surgical setting.

Within the last few years, the opioid epidemic has consumed the country and provisional data from the CDC found that there were almost 100,000 reported drug overdoses last year. What changes have medical professionals been making to adapt to these statistics?

The ongoing opioid epidemic has increased awareness around the potential negative side effects that patients may experience when taking these prescribed medications for pain after surgery. While opioids have long been prescribed for postsurgical pain management, these medications come with the risk of potential side effects such as nausea, vomiting, dizziness, and addiction or dependence. In fact, a survey found that one-in-10 patients prescribed an opioid to manage postsurgical pain report becoming addicted to or dependent on opioids.

Armed with knowledge that the surgical setting is a potential gateway for opioid addiction, there has been significant medical advancements made in the recent years that can help minimize the need for opioids. The availability of non-opioid options has created a new vision for recovery after surgery and shown that it is possible to reduce risks of long-term consequences.

Can you share more about non-opioid options for postsurgical pain?

There are numerous non-opioid options that are available over the counter for patients like non-steroidal anti-inflammatories (NSAIDS), acetaminophen, among others. For my patients, I have been using a long-acting numbing medication that is injected into the surgical area during the procedure. This long-acting local anesthetic acts as a numbing agent and prevents patients from experiencing pain for the first few days following surgery – when pain is often at its worst.

This option allows me to write fewer opioid prescriptions as it provides equivalent pain control. As patients are reducing the number of opioids being consumed, they are also avoiding the negative side effects that are associated with these medications.

Why is it important for medical professionals to educate their patients about non-opioid options?

As an anesthesiologist, I’m in a unique position where I see patients across all surgical areas – and the impact non-opioid options have for all types of procedures. I am passionate about providing my patients with effective care while eliminating unnecessary exposure to opioids whenever possible. I educate my patients on all their options prior to procedure to ensure that their concerns are heard, and they receive the care that they deserve. For women’s health surgeries like C-section deliveries, I explain the benefits of non-opioids and how they may help a new mother recover quicker. 

Making my patients aware of their alternative options is a critical part of my job as I focus on pain management as a whole. Educating my patients not only allows me to reduce the number of opioids I prescribe, but it improves the patients’ recovery journey.

How have non-opioid options impacted and benefited women’s health procedures specifically?

Almost immediately after giving birth, women are expected to bounce right back. While opioids have been seen as the go-to pain management option for C-section deliveries, they can cause unpleasant side effects – ultimately delaying recovery. Non-opioid options like a long-acting numbing medication I use to manage pain following C-sections can allow mothers to be more present in the hours following their delivery and get back home quicker.

Non-opioid options to manage postsurgical pain have allowed for patients to have a better overall recovery experience for other women’s health surgeries as well. Many patients have become more reluctant to go into a hospital setting, and non-opioids can support a quicker discharge. Research has also found that women are 40% more likely than men to become newly persistent users of opioids following surgery – further validating the need for clinicians to offer alternatives.

After surgery, women tend to be eager to “get back to normal” and “bounce back.” Why do you think that is?

Women typically are juggling a lot and studies show that they make over 80% of the healthcare decisions in the US alone. After having a C-section, women are expected to sit up, walk, breastfeed, hold their newborn, all within the first 24 hours. With the expectation of getting right back on their feet after a C-section, it is not surprising that they want to return to their new normal.

A recent survey supported this, finding that nearly all women (96%) ages 30-50 who have had a surgical procedure are anxious to return home and get back to their daily routine. The survey revealed that 43% cite caregiving responsibilities as the top reason and 31% of respondents say getting back to work faster is a key motivator for a rapid rebound after. Non-opioid options can help address these concerns and get women back home sooner.  

What should women do if their doctors prescribe opioids and do not offer any alternatives?

This is an important question as we know that 84% of women have concerns related to being prescribed or taking opioids, but only 26% of women have discussed non-opioid options before surgery. It is important for patients to ask their health care provider if non-opioids would be an option for them well before their surgery date. If a woman feels as if their concerns are being dismissed, they should seek out another provider who is aligned with their recovery goals. Women need to be advocates for themselves and should feel empowered to speak about any concerning issues prior to surgery. Pain is different for everyone, and the decision about pain management should be a two-way dialogue between patient and clinician.

For more information, women can check out www.WeAreWomensHealth.com to learn about recovery after surgery, preparing your body for birth, advocating for non-opioids and other important issues that impact women’s health. Patients preparing for surgery can also visit PlanAgainstPain.com to download a doctor discussion guide to help facilitate these important conversations. 

This article is sponsored by Pacira BioSciences, Inc., for which Dr. Shastri is a consultant.