GRANTS. Axel Wolf, a chief nurse, anesthetist, and associate professor at the Institute of Health and Care Sciences, has been awarded SEK 5.5 million from the Swedish Research Council to investigate whether there are adequate, or even better, alternatives to opioids in bariatric surgery.
Pain relief without morphine during surgical procedures may sound completely unthinkable to many. Opioids, including morphine, are potent painkillers that provide relief through the central nervous system. They have long been a fundamental treatment used in surgery and as anesthesia. Still, it has been shown that opioids have many undesirable side effects and that they can even increase pain.
Many and serious side effects
The explosive increase in opioid-related mortality and public consumption and abuse of opioid drugs in the Western world have become a major global problem.
It has also become apparent that opioids can have many undesirable effects. Among other things, they can paradoxically heighten pain (hyperalgesia), impair breathing, cause nausea and bladder or bowel problems, and suppress the immune system. “As a result, there are good reasons to find alternatives,” says Axel Wolf, project manager.
Person-centered approach leads to good anesthesia care
Axel Wolf specializes in person-centered care, which means increased patient participation in care and treatment, a crucial factor in high-quality healthcare. Innovative techniques for customizing anesthesia are useful for attaining the goal of person-centered care.
The overall purpose of Wolf’s research project is to evaluate the short, medium, and long-term effects of opioid-free regimens with or without person-centered care in patients undergoing bariatric surgery. The project focuses on bariatric surgery patients because weight loss increases the uptake of opioids from the intestine, increasing the risk of long-term opioid consumption, chronic pain, and side effects.
“We are incredibly excited to be able to study the effects of opioid-free anesthesia and postoperative recovery—something in demand both nationally and internationally.”
Alternatives
When the patient is put into a chemically induced coma in general anesthesia, opioids are used to control the hormonal stress reaction that occurs during surgery. However, since a patient in a chemically induced coma cannot perceive pain, the theory behind opioid-free anesthesia is that other medications can be used to control the hormonal stress reaction.
Transcutaneous nerve stimulation (TENS) is a non-pharmacological way to relieve pain by sending a mild electrical current through electrodes on the skin. TENS used in postoperative pain has been shown to provide pain relief, shorten the patient’s hospital stay, and reduce the risk of nausea after surgery. Since TENS units can be purchased in retail outlets, they are an easily accessible and safe self-care and pain treatment.
Today, pharmacological and non-pharmacological strategies can radically reduce the need for opioid use in bariatric surgery. In his study, Axel Wolf wants to combine and compare opioid-free anesthesia, TENS, and person-centered care into a care concept that can be evaluated, implemented, and scaled to other healthcare contexts. This study also explores patient experiences of opioid-free pain relief and recovery after surgery.
“It is very gratifying for the research team to receive an additional confirmation of the study’s innovation ambitions with significant benefit for the patient and the high international standard maintained by the team.”
New strategies needed
Wolf believes that we need to offer a more systematic, multimodal treatment strategy as an important cornerstone of future anesthesia and pain relief.
“With this grant, we now also have a great opportunity to study different monitoring techniques in opioid-free anesthesia and to develop future person-centered care structures in anesthesia.”
The team expects that this can be linked to the concept of Local Health Care.
“I hope we can soon also start investigating several other patient groups and perhaps even children in the future,” says Axel Wolf.
The study has previously received funding from the Center for Person-Centered Care (GPCC) and the Agreement for Cooperation on Medical Education and Research (ALF).
Follow Wolf and his research colleagues here: www.gothenburgpainlab.com.
BY: LOVISA AIJMER
