Alumni Lecture Series: Evidence-Based Analgesia: Alternatives to Opioids

Sep, 2018

Penn Dental Medicine
William W. M. Cheung Auditorium

The Alumni Lecture Series offers free continuing education credit for alumni along with an evening of networking with fellow alumni. Dr. Elliot Hersh, Professor in the Department of Oral & Maxillofacial Surgery/Pharmacology, will be the evening’s speaker.

Click here to ATTEND IN PERSON>>

Click here to PARTICIPATE VIRTUALLY>> (Advance registration is required)

Course Description
This presentation will first review the biochemical and physiological mechanisms behind post-surgical dental pain and then discuss various double-blind randomized controlled trials on the efficacy of various analgesic agents following the surgical removal of impacted third molar teeth. A discussion of the “drug seeking patient” and the prescription opioid abuse crisis will be highlighted. Opioid-sparing strategies including the combination of an NSAID with acetaminophen and the potential utility of bupivacaine will be discussed. The final portion of this discussion will focus on meta-analysis data for various analgesics in both dental pain and other post-surgical pain models. In other words, which analgesics consistently lead the pack and which are consistently dogs (i.e. “opioids in many situations”). An updated flexible analgesic schedule which was published in JADA in August 2013 will also be introduced.

Learning Objectives

  • Discuss the utility of the oral surgery pain model.
  • List various peripheral chemical mediators which contribute to post-surgical dental pain.
  • Compare the analgesic efficacy of NSAIDs to single entity and acetaminophen combination oral opioids in randomized placebo controlled double-blind oral surgery pain studies.
  • Describe the rationale for combining opioid with non-opioid analgesic agents.
  • Compare the short-term side effect profile of NSAIDs versus opioids.
  • Identify potentially addicting drugs that high school students often misuse
  • Discuss the potential opioid-sparing effect of combining an NSAID with acetaminophen and the administration of liposomal bupivacaine following surgery.
  • Discuss meta-analysis data on the numbers needed treat (NNT) to obtain one additional patient with at least 50% maximum pain relief beyond the placebo treatment.

Speaker Biography
Dr Hersh is currently a Professor of Pharmacology/Oral Surgery at the University of Pennsylvania School of Dental Medicine. He received his DMD degree from UMDNJNJDS in 1981 and his MS and PhD degrees from UMDNJ – Graduate School of Biomedical Sciences in 1983 and 1988 respectively. Since arriving at the PENN in 1988 Dr Hersh has won the Dental School’s Excellence in the Teaching of Basic Science Award 20 different times and was also presented with a University Lindback Award in 1993, the highest teaching honor in the entire University. He has published more than 150 scientific articles, abstracts and book chapters in the areas of dental pharmacology, drug interactions, analgesics and local anesthetics. His scholarly and research contributions in the areas of local anesthesia and pain control were recognized by the International Association of Dental Research in 2007 when he was presented with the Distinguished Scientist Award in Pharmacology, Therapeutics and Toxicology. Dr Hersh states “that while the research accolades are nice, the most important thing I do is sharing this knowledge with my students and other dental professionals.”