Doctors "freeze pain" to avoid prescribing opioids post-surgery

BROWN COUNTY, Wis. (WBAY) - There's excitement in the medical community over a breakthrough treatment now being offered in Northeast Wisconsin in an effort to "kill the pill" and prevent drug addiction.

"I think in the next decade, we're going to be able to get people through surgeries that are traditionally very painful without having to take any narcotic medications, which will prevent addictions," says Dr. Robert Limoni, an orthopedic surgeon with BayCare Clinic.

Doctors at BayCare Clinic in Green Bay are trying a new approach to treating knee surgery pain that avoids prescribing opioids.

A few weeks ago, Target 2 Investigates got an inside look as undercover drug agents packed up and disposed of more than 60,000 pounds of unused medications in Wisconsin as part of a semi-annual drug take back collection.

We found an astounding 7.5 million prescriptions were written for controlled substances in Wisconsin, just through October first of this year. Nearly half of those were for opioids.

But a new procedure done pre-surgery is helping doctors eliminate having to give patients opioids post-surgery for what they classify as one of the most painful kinds of surgeries they perform.

Marlene Kotarski is one of those patients and still can't believe her knee pain is completely gone just a few short months after surgery.

"I was told I needed a revision, which I wasn't happy about whatsoever, because I had a pretty rough recovery after the first knee replacement," says Marlene.

But this time, her doctors at BayCare Clinic suggested a new treatment, called iovera (with a lower-case "i"), before surgery, that would block pain for two months after it.

"I really had to admit, I did not have the pain. I didn't even really need the Tylenol," she says.

The difference this time? Laughing gas, or nitrous oxide, is used to cool a needle which is then inserted just under the skin around the peripheral nerves in the knee. That coolness affects how the nerves feel pain for months after.

"It basically freezes or stuns it for about two months," explains Dr. Limoni. "The nerve regenerates and it wears off, so after you get through the portion of the recovery that's painful, your feeling returns to normal."

Limoni says doctors are constantly trying to prescribe fewer opioids.

"Our goal, in the next five to ten years, is to kill the pill. We want to get people through these surgeries without having to take any narcotic medications and not be at fault for creating an addict," says Dr. Limoni.

Unlike similar, older treatments, he says iovera can be given in an office and is covered by most insurance. Dr. Limoni says while it's only used for knees right now, it's being looked at for hips and shoulders, too. He says, in some cases, it can be used to delay surgery for patients who might need to lose weight or face other medical issues.

Marlene loves the idea of being opioid-free.

"Now that you hear about all this opioid problems in the world, you think, wow, this might be the next product out there that you don't need all those harmful drugs," she adds.

BayCare Clinic says it's been offering iovera since January.

We checked with other providers in our area. ThedaCare says it will start offering iovera next week. Prevea Health says it doesn't currently offer it, but plans to the near future. We have not heard back from Bellin Health.


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