Miami Thoracic Surgeons Achieve Pain Control With Minimal or No Opioids Interview with:
Dao Minh Nguyen, MD, MSc FRCSC FACS
Thoracic Cancers Group Go-Lead
Sylvester Comprehensive Cancer Center
University of Miami Miller School of Medicine What is the background for this study?

Response: Patients undergoing thoracic surgery operations experience significant acute incisional pain as well as chronic pain many months after.

The mainstay of treatment is based on frequent use of potent and addictive-prone opioids such as hydromorphone, oxycodone at high dosages and long duration.
There is a high incidence of persistent opioid users and chronic opioids users in surgical patient population. This certainly contributes to the opioid epidemic in the USA and worldwide.

We implemented a peri-operative care protocol for patients undergoing thoracic surgery operations called Enhanced Recovery after Thoracic Surgery (ERATS). The overarching goal of ERATS is to streamline care for thoracic surgery patients particularly in the postoperative period to mitigate pain with opioid-free strategy, to minimize postoperative complications, rapid return to baseline states and safe, early discharge home. This protocol follows guidelines of the ERAS principles and is developed for thoracic patients to address their unique needs.

Once pain is adequately addressed with opioid-free strategy with elimination of opioid-associated side effects, rapid recovery after surgery can be achieved.

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Painful Bunions: Risk Factors for Failure of Corrective Surgery

Dr. Johnson Interview with:
Matthew Johnson, D.P.M.
Assistant Professor
Department of Orthopaedic Surgery
University of Texas Southwestern Medical Center What is the background for this study?

Response: There is a paucity of literature attempting to characterize risk factors for nonunion of the Lapidus bunionectomy. Would you briefly describe what is meant by a bunion?

Bunion with cornDermNet NZ image

Response: Bunions are a chronic painful bump that forms on the base of the big toe when the long metatarsal bone shifts toward the inside of the foot and the phalanx bones of the big toe angle toward the second toe.

Policymakers Can Mitigate Prescription Opioid Misuse Associated with Delayed Dispensing for Pain Relief after Procedures Interview with:
Ping ChuaMD, PhD
Department of Pediatrics
Susan B. Meister Child Health Evaluation and Research Center
University of Michigan Medical School
Department of Health Management and Policy
University of Michigan School of Public Health, Ann Arbor  What is the background for this study? 

Response: Opioid prescriptions written by dentists and surgeons are almost always written for the immediate relief of acute pain after procedures. However, current federal and state laws allow these prescriptions to be dispensed well after the time that they are written. When this occurs, that could be a potential sign that the prescription was used in a time frame or for a reason other than intended by the prescriber, both of which are forms of prescription opioid misuse.

Minimally Invasive Spinal Surgery for Leg or Back Pain Linked to Improved Pain Relief and Function Interview with:
Dr. Mohamad Bydon MD
Professor of Neurosurgery
Mayo Clinic
Rochester, Minnesota

:Dr. Bydon MD  What is the background for this study?

Response: Patients presenting with back or leg pain due to degenerative lumbar spine disease often undergo spinal fusion to mitigate the symptoms and halt the progression of the disease. What are the main findings?

Minimally invasive surgery (MIS) in the lumbar spine encompasses a variety of techniques, such as percutaneous screw placement and operation via tubular retractors, and aims to limit the distortion of patients’ anatomy as much as possible. Eventually, compared to open fusion, MIS fusion is associated with decreased muscle destruction, incision size, and time-to-mobilization.

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