Many medical specialties have come to a crossroads where they must reconsider how they handle patients’ pain in light of the opioid crisis. This week, the American Association of Oral and Maxillofacial Surgeons (AAOMS) released prescribing guidelines that call for ibuprofen instead of opioids for pain.
AAOMS recommends ibuprofen as a first-line therapy for patients’ acute and post-surgical pain and notes that simultaneous use of ibuprofen and acetaminophen can rival opioids in their analgesic effect.
But practitioners should also use their judgment to manage pain, according to the recommendations. For surgeons that prescribe opioids, AAOMS recommends beginning with the lowest possible effective dose for the shortest duration possible. They are also encouraged to use state prescription-drug monitoring programs and to discuss opioid risks with patients.
Guidelines advise that extended-release opioids should be avoided and reference the Centers for Disease Control and Prevention's guidelines for prescribing opioids for chronic pain.
According to AAOMS, surgeons can consider use of corticosteroids during surgery to limit swelling and use a long-acting local anesthetic to postpone the onset and severity of post-surgical pain.