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Are Postoperative Narcotics Necessary?

Are Postoperative Narcotics Necessary? Abstract The routine liberal administration of narcotics to the postoperative patient is a deeply rooted surgical tradition based on the erroneous impression that devastating pain is the inevitable consequence of a major surgical procedure. It is the purpose of this paper to assess the factors relating to pain in the postoperative period and to report an experience with a large consecutive series of surgical patients who have received (and required) either very small doses of narcotics or none at all. From observations on laboratory animals and human infants (whose pain threshold has been demonstrated to be lower than that of adults1), it is notable that major pain and discomfort are rarely evident after surgical procedures. It is also well known that a person can sustain major tissue damage in war combat or in an athletic contest and yet continue in active motion with minimal discomfort, sometimes being completely unaware of References 1. Chapman, W. P., and Jones, C. M.: Variations in Cutaneous and Visceral Pain Sensitivity in Normal Subjects , J Clin Invest 23:81-91, 1944.Crossref 2. Beecher, H. K.: Measurement of Subjective Responses: Quantitative Effects of Drugs , New York: Oxford University Press, 1959. 3. Bishop, G. H.: quoted by Beecher,2 p 6, from a personal communication. 4. Hardy, J. D.; Wolff, H. G.; and Goodell, H.: Pain Sensations and Reactions , Baltimore: The Williams & Wilkins Company, 1952. 5. Read, G. D.: Childbirth Without Fear: The Principles and Practice of Natural Childbirth , New York: Harper & Brothers, 1944. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Are Postoperative Narcotics Necessary?

Archives of Surgery , Volume 87 (6) – Dec 1, 1963

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Publisher
American Medical Association
Copyright
Copyright © 1963 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1963.01310180028007
Publisher site
See Article on Publisher Site

Abstract

Abstract The routine liberal administration of narcotics to the postoperative patient is a deeply rooted surgical tradition based on the erroneous impression that devastating pain is the inevitable consequence of a major surgical procedure. It is the purpose of this paper to assess the factors relating to pain in the postoperative period and to report an experience with a large consecutive series of surgical patients who have received (and required) either very small doses of narcotics or none at all. From observations on laboratory animals and human infants (whose pain threshold has been demonstrated to be lower than that of adults1), it is notable that major pain and discomfort are rarely evident after surgical procedures. It is also well known that a person can sustain major tissue damage in war combat or in an athletic contest and yet continue in active motion with minimal discomfort, sometimes being completely unaware of References 1. Chapman, W. P., and Jones, C. M.: Variations in Cutaneous and Visceral Pain Sensitivity in Normal Subjects , J Clin Invest 23:81-91, 1944.Crossref 2. Beecher, H. K.: Measurement of Subjective Responses: Quantitative Effects of Drugs , New York: Oxford University Press, 1959. 3. Bishop, G. H.: quoted by Beecher,2 p 6, from a personal communication. 4. Hardy, J. D.; Wolff, H. G.; and Goodell, H.: Pain Sensations and Reactions , Baltimore: The Williams & Wilkins Company, 1952. 5. Read, G. D.: Childbirth Without Fear: The Principles and Practice of Natural Childbirth , New York: Harper & Brothers, 1944.

Journal

Archives of SurgeryAmerican Medical Association

Published: Dec 1, 1963

References