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Momentum Builds for Opioid-Free Total Joints
Patient engagement, targeted nerve blocks and multimodal pain cocktails are keys to preventing debilitating post-op pain.
Dan Cook | Editor-in-Chief
Publish Date: August 15, 2022   |  Tags:   Anesthesia Pain Management Patient Experience Orthopedics
Joint cocktail
EVOLVING CARE Surgeons are beginning to view the elimination of opioids from perioperative protocols in much the same way they began to explore the possibility of moving joint replacements to outpatient facilities.   |   Pamela Bevelhymer

Mo Halawi, MD, grew up in Lebanon, where he remembers his grandmother receiving acetaminophen to manage her pain after a major surgery. When he began practicing medicine in America, he was surprised to see surgeons passing out opioids like candy. “In many other countries, over-the-counter medications are sufficient to treat post-op pain,” says Dr. Halawi, an orthopedic surgeon and joint replacement specialist in Houston. “The perception of pain is different in the U.S., where there’s a reflexive culture to use opioids as an immediate intervention. But opioids cause a host of unwanted side effects after surgery. Instead of complaining about pain, patients suffer from non-surgical issues such as constipation, nausea and vomiting.”

In 2017, Dr. Halawi began to reduce the amount of opioids he gave to total knee replacement patients. He continually assessed patient feedback throughout the process and received very few calls from patients complaining of excessive post-op pain. A year later, he wrote his last script and has never regretted the decision to go opioid-free. Dr. Halawi, like an increasing number of providers, discovered multimodal care pathways help patients survive the acute pain of surgery — and thrive during their recoveries.

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