Ibuprofen After Wisdom Tooth Surgery: Opioid-Free Pain Management | Penn Precision Medicine


(soft music) – Opioid pain medications
have an important role in the treatment of
acute postoperative pain. However, they are also highly addictive. After surgery, many patients receive prescriptions for two to five times more doses than they actually use. This overprescribing of opioids has contributed to the current addiction epidemic in the United States. The addiction risk
affects not only patients, but, also, their families and friends. 2/3 of individuals who become addicted began using leftover pills
prescribed for others. Adolescents and young adults are especially at risk for opioid misuse and vulnerable to becoming addicted. One strategy to address the opioid crisis is to reduce opioid prescriptions by optimizing pain management with nonaddictive medications. Nonsteroidal anti-inflammatory
drugs, or NSAIDs, are such nonaddictive analgesics. With support from the Penn
Center for Precision Medicine, we have formed a multidisciplinary team of researchers, pain
physicians, and oral surgeons to develop a personalized approach for postoperative pain
management with NSAIDs. We are initially focusing on impacted third-molar or wisdom tooth extraction surgery, because this is often the first occasion adolescents and young adults are described an opioid. NSAIDs can be as effective as prescription opioids in treating pain following third-molar extraction surgery. However, some patients experience only limited pain relief with NSAIDs and a few experience
no pain relief at all. To avoid undertreating those patients, opioids are routinely prescribed. This results in an
overprescription of opioids in the majority of patients
who do not require them or require only minimal dosing. Can we predict those individuals in whom NSAIDs may be used effectively and opioids avoided? To address this question, we are conducting a clinical trial which systematically explores the variability and pain relief with the NSAID ibuprofen. We are investigating genetic and epigenetic factors that may predict the inflammatory response
following surgery and how that influences the degree of pain relief with ibuprofen. Being able to identify patients in advance who will have substantial
pain relief with an NSAID will help limit unnecessary
prescriptions of opioids. And, importantly, this will also ensure that patients who are unlikely to achieve pain relief with an NSAID alone have access to additional analgesics. I am Dr. Tilo Grosser, and this is Precision Medicine at Penn. (soft music)

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