4 ms·

I also thought about epidural. Is that a non addictive way to give pain relief (extreme yes)

OJFord 1y ago
It is used surgically too (not just in childbirth as you might associate it) but it's a relatively risky procedure vs. a venous injection or pill to swallow.
- Findecanor 1y ago
  Indeed. After my first bowel surgery, I woke up to a wall of pain — because the epidural did not work. The intense pain caused me to throw up, repeatedly, which put strain on the fresh surgery and the stitches. After what felt like an eternity, I myself noticed a wetness on my shoulder onto which a broken hose adaptor had leaked. After that was replaced, there were no further issues. Thankfully, the stitches had held, and I didn't get a hernia. Also, I did have to carry a pee-bag while the epidural was in, because the epidural made me lose control of my bladder. And the epidural itself left a scar.
dcminter 1y ago
Epidural is surely just the method of administration (into the spinal fluid) where the actual painkiller administered is opioids, though, right? Meanwhile my understanding of Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) was that they were exactly that by definition - Anti-Inflammatories with pain being reduced by reducing the immediate cause of it, inflammation, not by interfering with the actual mechanisms of pain. I guess one could consider general anaesthesia (laughing gas, ether, and more modern successors) to be "painkillers" too but they're obviously not quite the same category of thing. Anyway, I enjoyed the article - it would be interesting to hear the author give their own reasons for not accounting for NSAIDs.
- atombender 1y ago
  Paracetamol/acetaminophen is not an NSAID, though. NSAID is effectively a shorthand for COX inhibitor; the term NSAID was coined at a time when the mechanism wasn't fully understood, and all other anti-inflammatories were steroids. Paracetamol does target COX-2, but does so in a way that doesn't really have any effect on inflammation. Its main mechanism of action is as an AM404 inhibitor.

It is used surgically too (not just in childbirth as you might associate it) but it's a relatively risky procedure vs. a venous injection or pill to swallow.

Findecanor 1y ago
Indeed. After my first bowel surgery, I woke up to a wall of pain — because the epidural did not work. The intense pain caused me to throw up, repeatedly, which put strain on the fresh surgery and the stitches. After what felt like an eternity, I myself noticed a wetness on my shoulder onto which a broken hose adaptor had leaked. After that was replaced, there were no further issues. Thankfully, the stitches had held, and I didn't get a hernia. Also, I did have to carry a pee-bag while the epidural was in, because the epidural made me lose control of my bladder. And the epidural itself left a scar.

dcminter 1y ago

Epidural is surely just the method of administration (into the spinal fluid) where the actual painkiller administered is opioids, though, right? Meanwhile my understanding of Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) was that they were exactly that by definition - Anti-Inflammatories with pain being reduced by reducing the immediate cause of it, inflammation, not by interfering with the actual mechanisms of pain. I guess one could consider general anaesthesia (laughing gas, ether, and more modern successors) to be "painkillers" too but they're obviously not quite the same category of thing. Anyway, I enjoyed the article - it would be interesting to hear the author give their own reasons for not accounting for NSAIDs.

atombender 1y ago
Paracetamol/acetaminophen is not an NSAID, though. NSAID is effectively a shorthand for COX inhibitor; the term NSAID was coined at a time when the mechanism wasn't fully understood, and all other anti-inflammatories were steroids. Paracetamol does target COX-2, but does so in a way that doesn't really have any effect on inflammation. Its main mechanism of action is as an AM404 inhibitor.