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Lowcounty surgeon prescribing fewer opioids, part of growing movement

(WCIV)

Imagine recovering from surgery without prescription painkillers. It's a growing movement in medicine. Narcotics have been the go-to remedy for pain for decades, but the opioid crisis has doctors rethinking pain management.

Some local surgeons have dramatically cut back on administering narcotics.

"As surgeons, we prescribe a vast majority of these medications so we need to take some responsibility," said Dr. Ken Mitchell, a bariatric surgeon with Roper St. Francis Physician Partners. "It's our duty to try alternative measures to see if we can achieve the same type of pain control and discomfort management with other modalities other than narcotics."

Mitchell performs procedures like gastric bypass and gastric band surgery. He said minimally invasive techniques have helped cut down on recovery time.

Over the last 18 months, Mitchell said their practice has reduced the number of narcotic prescriptions written by 97-percent.

"In the year 2017, we prescribed almost 100 prescriptions for narcotics in that calendar year," he said. "In this calendar year, through June, I think we've had primary bariatric surgical cases and we've written three prescriptions."

Despite decades of use, Mitchell said narcotics are not always necessary and cause more complications, especially in bariatric patients. Narcotics often cause constipation and nausea, which can slow down recovery time.

Instead, he said they use Tylenol liberally and other medications like Gabapentin and Toradol. Part of the protocol includes consumption of sports drinks like Gatorade, up to two hours before surgery. Usually, patients are told to fast for 12 hours leading up to surgeries involving anesthesiology.

"The whole part of this enhanced recovery protocol is that we give people medication before they hurt," he said. "A saline bag requires an IV, a saline bag also is at risk for infection because you have an IV," Mitchell said. "[Oral consumption] is something your body is used to."

Through this effort, Mitchell said they've also managed to cut the length of hospital stays by 35-percent.

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