Post Surgical Pain Management

Pain is best managed by use of ibuprofen, (Advil, Motrin) and acetaminophen (Tylenol) in combination or alone if you can take these medications. Alternate ibuprofen 400mg and acetaminophen 500mg, taking each every four hours. Do not exceed 4000mg of acetaminophen in a day. Prescription opioids can also be used to help relieve moderate-to-severe pain and are often prescribed following a surgery or injury. These medications can be an important part of treatment but also come with serious risks. It is important to work with your health care provider to make sure you are getting the safest, most effective care. Prescription opioids carry risks of addiction and overdose, especially with prolonged use. An opioid overdose, often marked by slowed breathing, can cause sudden death. The use of prescription opioid can have a number of side effects as well, even when taken as directed.

PRESCRIPTION OPIOIDS: WHAT YOU NEED TO KNOW

1. Other medications are more effective than Opioids in treating dental pain

• Opioids are not the most effective or longest-lasting options available for relief from acute dental pain.
• Narcotics should be a last resort
• Opioids certainly should not be the first option, for adults a combination of ibuprofen and acetaminophen was superior to any medications that contained opioids that were studied.

2. What are the risks and side effects of Opioids?

• Tolerance- meaning you might need to take more of a medication for the same relief
• Physical Dependence- meaning you have symptoms of withdrawal when a medication is stopped
• Increased sensitivity to pain
• Depression, confusion
• Nausea, vomiting, dry mouth, constipation
• Low levels of testosterone that can result in low energy and strength
• Sleepiness, dizziness, itching and sweating

3. Risks are greater with:

   • History of drug misuse, substance use disorder, or overdose
   • Mental health conditions (such as depression or anxiety)
   • Sleep Apnea
   • Older age (65 years or older)
   • Pregnancy

4. Avoid alcohol while taking prescription Opioids. Also unless specifically advised by your health care provider, medications to avoid include: 

• Benzodiazepine (Xanax or Valium)
• Muscle Relaxants (Soma or Flexeril)
• Hypnotics (Ambien or Lunesta)
• Other prescription opioids

5. If you are prescribed Opioids for pain:

• Never take opioids in greater amounts or more often than prescribed
• Work together to create a plan on how to manage your pain
• Talk about ways to help manage your pain that do not involve prescription opioids
• Talk about any and all concerns and side effects
• Help prevent misuse and abuse
• Never sell or share prescription opioids
• Store prescriptions opioids in a secure place and out of reach of others (this may include visitors, children, and family)
• Safely dispose of unused prescription opioids: Find your community drug take-back program or your pharmacy mail-back program, following guidance from the Food and Drug Administration (fda.gov/Drugs/ResourcesForYou)
• Visit cdc.gov/drugoverdose to learn about the risk of opioid abuse and overdose
• If you believe you may be struggling with addiction, tell your health care provider and ask for guidance or call SAMHSA’s National Helpline at 1-800-662-HELP