Opioid-Free Spine Surgery: Embracing a New Era - Awake Spinal Fusion
Awake Spinal Fusion is a minimally invasive procedure that doesn’t require general anesthesia. Instead of a lengthy hospital stay, you’re up and about in just a few hours.
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Opioid-Free Spine Surgery: Embracing a New Era

By Dr. Alok Sharan
Mar. 28, 2024

Opioid-free spine surgery is gaining tremendous traction. Traditionally, opioids have been a cornerstone of pain management in surgical procedures, including those involving the spine. However, with the growing opioid crisis and increasing awareness of the risks associated with these medications, medical professionals are exploring alternative approaches to pain management. At the Spine and Performance Institute we have been working hard to make spine surgery safer, a better experience, while minimizing the use of opioids.  In this blog post, we delve into the concept of opioid-free spine surgery, its benefits, and the evolving practices shaping the future of spinal care.

Opioid Free Spine Surgery


Understanding Opioid-Free Spine Surgery:
Opioid-free spine surgery refers to surgical interventions on the spine that minimizes or entirely eliminates the need for opioid-based pain medications during and after the procedure. This approach relies on a multifaceted strategy that incorporates various non-opioid analgesic techniques and interventions to effectively manage pain while reducing the reliance on addictive narcotics.

Key Components of Opioid-Free Spine Surgery:
1. Multimodal Pain Management: A cornerstone of opioid-free spine surgery is the utilization of multimodal pain management techniques. This approach combines different classes of medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, muscle relaxants, and nerve block injections, to target pain through different pathways, thereby reducing the need for opioids.


2. Regional Anesthesia: Regional anesthesia techniques, such as spinal anesthesia and peripheral nerve blocks, play a crucial role in opioid-free spine surgery. By targeting specific nerves responsible for transmitting pain signals, these techniques provide effective pain relief during and after surgery, minimizing the need for systemic opioids.  Dr. Sharan has been a pioneer of the Awake Spinal Fusion technique which avoids general anesthesia, and uses spinal and regional anesthesia instead.


3. Enhanced Recovery After Surgery (ERAS) Protocols: ERAS protocols focus on optimizing perioperative care to accelerate recovery and reduce postoperative complications. These protocols may include preoperative patient education, early mobilization, nutritional optimization, and judicious fluid management, all of which contribute to minimizing pain and enhancing overall outcomes without relying on opioids.  At the Spine and Performance Institute a significant portion of our practice is devoted to using IV infusions with various nutritional elements to enhance and optimize patients prior to surgery.


Benefits of Opioid-Free Spine Surgery:
1. Reduced Risk of Opioid Dependency and Addiction: Perhaps the most significant advantage of opioid-free spine surgery is the decreased risk of opioid dependency and addiction. By minimizing exposure to opioids, patients are less susceptible to the adverse effects and addictive properties associated with these medications, thus promoting safer pain management practices.


2. Faster Recovery and Rehabilitation: Opioid-free spine surgery is often associated with faster recovery and shorter hospital stays compared to traditional approaches reliant on opioids. By employing a multimodal pain management strategy and emphasizing early mobilization, patients can return to their daily activities sooner, facilitating a smoother rehabilitation process.  Many patients are able to go home the same day after spinal fusion surgery.


3. Improved Patient Satisfaction and Outcomes: Studies have shown that patients undergoing opioid-free spine surgery report higher satisfaction levels and improved postoperative outcomes compared to those receiving opioid-based pain management. By prioritizing alternative pain control methods, healthcare providers can enhance the overall patient experience and optimize long-term results.


At the Spine and Performance Institute Dr Sharan has been a pioneer in the use of an opioid free protocol called Awake Spine Surgery. Using a combination of IV infusions both before and after surgery, along with regional anesthetic techniques, many patients who undergo spine surgery do not need opioids.

Opioid-free spine surgery represents a paradigm shift in the field of spinal care, offering a safer, more effective approach to pain management while mitigating the risks associated with opioid use. By embracing multimodal pain management techniques, regional anesthesia modalities, and ERAS protocols, healthcare providers can optimize surgical outcomes, improve patient satisfaction, and contribute to the broader effort of combatting the opioid crisis. As research and clinical experience continue to evolve, the widespread adoption of opioid-free spine surgery holds promise for transforming the way we approach spinal interventions, ultimately enhancing the quality of care for patients worldwide.

Listen to Kevin speak about his experiences with Opioid Free Surgery Kevin Dairy Queen