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CT Ortho Surgeon Uses Time-Release Pain Med instead of Opioids
By Starling Physicians

Sep 12, 2018 - 3:11:33 AM

New Britain, CT - The path to opioid addiction often starts when a patient leaves the operating room. In fact, 1 out of 15 surgical patients goes on to long-term opioid use. Dr. Robert Belniak, an Orthopedic Surgeon with Starling Physicians, is offering a new opioid-free approach to pain management for knee and joint replacement surgery.

“The first few days after surgery is when a patient’s pain level is the most intense,” explained Dr. Belniak at Starling Physicians Orthopaedic Surgery and Sports Medicine Department. “After that, most patients should be able to manage with over-the-counter or prescriptive anti-inflammatory medications instead of narcotics.”

One way to ease that early post-operative pain is with an FDA approved local anesthetic called EXPAREL. Unlike conventional local anesthetics that wear off in a few hours, this drug is encapsulated in a series of tiny fat globules that act as a sort of time release device, maintaining pain control as long as three days. It provides non-opioid pain control and a 78% reduction in opioid use through the first 48 hours.

According to Dr. Belniak, the single injection of EXPAREL eliminates the need for catheters, pumps, and other medication delivery devices that may hinder recovery. Plus, less reliance on narcotic pain medications enhances recovery in other ways. Patients don’t suffer the side effects of nausea, vomiting, and constipation. And, they are able to get moving much faster after surgery.

During Drug Free Pain Management Awareness Month in September, Dr. Belniak is crusading for a comprehensive approach to pain relief in orthopedics. “Multimodal, opioid-reducing protocols are the recommended standard for improving recovery while reducing complications and cost,” notes Dr. Belniak. His ultimate goal is to create an opiate-free practice.

Dr. Belniak’s multimodal approach to reducing pain without narcotics involves:
Use of anti-inflammatory medications, muscle relaxants, neurotropic medications
Use of long lasting post-surgical analgesia
Pre-operative hydration. Patients have less post-operative nausea if they eat and drink closer to the surgery
Patient education prior to surgery to set expectations
Referral to Starling’s Pain Management specialist, Dr. Kayvon Alizadeh, for further pain management options if needed

“These techniques combined have proven to be highly effective for my patients,” said Dr. Belniak. “None of them are currently using opiates.”

Dr. Belniak is also an advocate for newer, less invasive surgical methods. He often performs knee and shoulder joint replacements on an outpatient basis using robotic assisted technology called MAKOplasty. The surgery involves use of innovative technology that enables specially trained orthopaedic surgeons to conduct partial or total knee replacement by using three-dimensional computer imaging and a robotic arm. This procedure can relieve pain caused by joint degeneration due to osteoarthritis and restore range of motion. And, since this surgery is less invasive than traditional knee replacement, surgery can be performed on an outpatient basis.

According to ANationInMotion.org, nearly half of American adults develop knee osteoarthritis in at least one knee in their lifetime. Currently, more than 600,000 knee replacements are performed each year in the U.S. Unfortunately, total knee replacement is one of the most common surgeries associated with an increased risk of chronic opioid use.

Dr. Belniak notes that combination of less invasive surgical methods and new options for pain control means patients can get the surgery they need with less time in the hospital, minimal pain, and be back on the feet in no time. “Many people considering orthopedic surgery are fearful of pain and delay surgery for that reason,” concluded Dr. Belniak. “With our new approach to pain management and outpatient surgery, we can get you up and moving faster so you can improve your quality of life.”

Starling Physicians is Connecticut’s leading multispecialty group. The practice is owned and led by physicians with a deep commitment to providing the highest quality care, while building enduring relationships with their patients. More than 300 physicians and other medical practitioners provide primary and specialty care across 27 specialties in 30 locations across Connecticut. For more information, visit www.starlingphysicians.com

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