THURSDAY, Feb. 27, 2025 (HealthDay News) — Powerful synthetic opioids are meant to serve as painkillers, but new research suggests their use during surgery might actually prompt worse pain during patients’ recovery.
The use of two types of synthetic opioid during surgery is linked to patients having a poor “pain experience” — a composite of the emotional, cognitive and mental aspects of pain, researchers said.
In fact, the use of remifentanil and sufentanil during surgery increased 27-fold a patient’s risk of suffering as they recover, researchers reported Feb. 25 in the journal Regional Anesthesia & Pain Medicine.
While opioid drugs can help quell pain following surgery, “their intraoperative administration — especially of potent agents like remifentanil and sufentanil — may paradoxically contribute to heightened postoperative pain,” concluded the research team led by Dr. Axel Maurice Szamburski, an associate professor of anesthesiology with the University Hospital Center Nice Pasteur Hospital in Nice, France.
Most patients experience moderate to severe pain following surgery, researchers said in background notes. This isn’t just unpleasant for them, but can hinder their recovery and increase their risk of complications.
“Identifying key determinants of a poor pain experience could help uncover areas of care that, when addressed, may improve patient satisfaction and reduce the risks of both acute and chronic postsurgical pain,” researchers wrote.
For this study, researchers analyzed data gathered for 971 patients as part of a clinical trial aimed at evaluating the effectiveness of sedatives given prior to surgery.
The patients, all younger than 70, had been randomly assigned the day before surgery to receive the sedative lorazepam, a placebo, or nothing at all.
Their surgeries took place at five French teaching hospitals. About 37% of the surgeries were orthopedic or spinal; 29% involved the ear, nose or throat; and 15% digestive, the study says.
Of those patients, 271 (28%) reported a poor pain experience on their first day following surgery, based on a questionnaire aimed at capturing all the mental and physical aspects of pain.
The use of powerful opioids while patients were under general anesthesia increased their risk of pain during recovery by about 27 times, researchers found.
This is consistent with a known phenomenon called “opioid-induced hyperalgesia, where exposure to a high dose of opioids can lead to an increased sensitivity to pain stimuli,” researchers wrote.
Patients also were five times more likely to have serious pain if they have a severe chronic illness, and eight times more likely if they were given drugs following surgery to treat anxiety, results show.
People were 51% less likely to have pain if they were given no preoperative sedatives, and 71% less likely if they had undergone orthopedic surgery.
More information
The Cleveland Clinic has more on pain control after surgery.
SOURCES: BMJ, news release, Feb. 25, 2025; Regional Anesthesia & Pain Medicine, study, Feb. 25, 2025
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