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FDA-Approved Medication Shows Potential to Reduce Surgery Patients’ Need for Opioids
Findings from a recent study conducted by researchers in the Department of Anesthesia and Perioperative Medicine at the Medical University of South Carolina (MUSC) suggest that N-acetylcysteine (NAC)—a drug already approved by the US Food and Drug Administration—may help decrease patients’ pain levels and use of opioids after surgery.
“Can we stop giving opiates completely? Likely not,” study principal investigator Sylvia Wilson, MD, the department’s Jerry G. Reves Endowed Chair in Anesthesia Research, said in a news release. “Can we decrease the amount patients need? We should try.”
The pilot study, which was published in the journal Pain Management, looked at pain medication required by patients after undergoing spinal surgery. The patient population was chosen for the study because spinal surgery is a procedure that often results in chronic pain and exposure to higher levels of opioids before, during and after surgery, the researchers said in a news release.
The study’s first 20 participants were randomly divided into equal groups that received placebo or a small (50 mg/kg), medium (100 mg/kg), or large (150 mg/kg) dose of NAC. The next 30 patients received either placebo or the large NAC dose. Patients given NAC received 16% to 22% less opioids in their first 2 days post-surgery compared to the placebo group. The NAC group also took longer to request post-surgical pain medication and reported lower pain scores in the first 2 days after surgery.
Notably, the beneficial effect of NAC appeared to last longer than it was expected to remain in the body.
“We’ve seen the impact of giving this medication persisting, and I think that’s significant,” Dr Wilson, said. “We’re not seeing a rebound effect when that medication wears off.”
The MUSC researchers said it hopes to investigate the use of NAC to treat pain associated with other procedures to see if their findings will translate. They are currently enrolling patients undergoing minimally invasive hysterectomies in a larger trial.
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