I suppose if we get into semantics, anesthetics could be considered pain-killers in the true sense though I have heard that strong opiates dull physical and mental discomfort to an extreme level.
I was wondering if someone was having a wisdom tooth removed by a dentist and took a lot of morphine or heroin beforehand instead of choosing an anesthetic but didn’t ‘‘nod’’ off, would they experience discomfort? Would it be more effective than an anesthetic?
The only time I’ve had morphine*, and I was told it wasn’t very much (2mg?), was for a kidney stone. It wasn’t until later that I realized that I wasn’t really in any pain while I was there. At the time I was just a little bit fuzzy and not really thinking about it.
Maybe? But a local anesthetic, especially for something like that, really can’t be beat. It’s (in general/for most people) not about how much it dulls your pain, it’s that locals make it so there’s zero pain. The odd noises and having 4 hands in your mouth is far more uncomfortable than having a tooth torn out of your head.
*I take that back, IIRC, the few times I’ve had ‘twilight’ sedation, they used a morphine in the cocktail to knock me out.
As a physician, I would NOT recommend using opioids or other analgesics instead of an anesthetic for significant procedures where tissues are damaged. They will not blunt the initial acute pain much at all. Those nerves will send their pain signals with full intensity.
I’ve been involved in surgical procedures where the patient was allergic to local anesthetics and a wound needed debriding, and we used oral and IV morphine to reduce discomfort. The patient was absolutely MISERABLE. Now he did nod off quickly afterwards, but it was a harsh procedure.
In addition: One could give enough opioids to render one completely insensate to invasive procedures, but the amount necessary to do so would quite frankly be dangerously close to, if not actually within the range needed to cause respiratory arrest and death. So unless a skilled anesthesiologist is present and ready to support respiration AND give meds which reverse the effects of the opioid, one is asking for trouble to try to do significant surgery solely with opioids as the agent to control pain. Opioids can definitely be a vital adjunct to delivering adequate anesthesia/sedation for procedures, but not as the lone agent.
In the UK Morphine and Diamorphine (Heroin) are used for end of life pain relief.
They are powerful painkillers but the side effect of euphoria helps to relieve suffering.
Morphine was always the drug of choice for emergency trauma pain relief but often tends to be replaced by other meds if possible.
It depends somewhat on where the pain originates.
An elderly friend was suffering from terminal spinal cancer. At times, that caused a lot of pain, and it was not relieved by weaker drugs. Something about the pain being in/near the spinal cord, a direct pathway to the brain. Eventually, to relieve the pain. she had to be given morphine in very large doses – ones that her doctor said could have been fatal to a patient not used to morphine. On bad days, the dose needed often left her groggy and falling asleep.
The dose used was large enough that there was a fair risk that it could depress her breathing, possibly enough to be fatal. But her doctor said he had discussed that with her, and she was willing to take the risk. As she said, “if that happens, it’s not a bad way to go. And I’m prepared to go anyway. If I’m racked up with pain, or so doped up I just sleep, I’m no use to anyone anyway.”
She lasted several months, receiving a massive amount of morphine 2-3 times per week.
Were there reasons ketamine or some other disassociative wasn’t used in those cases? Doesn’t seem like they’d have been miserable if they’d fallen through the K-hole into space.
How come opioids don’t blunt the initial acute pain but dull the rest? What’s happening? Is it because most of the suffering is not in the initial sensory input but rather in the CNS processing/throughput and opioids mainly affect the throughput?
Morphine was handy. Ketamine wasn’t. The surgeon in charge went with morphine.
Damfino. We are still quite ignorant about just how pain meds work. Once well-accepted theories have turned out to be, if not completely wrong, at least very complex and much more nuanced than originally thought. The difference between analgesia and anesthesia is quite profound in and of itself, as is how our brain perceives those things and how drugs affect the nerves and neurotransmitters that carry those messages (or don’t carry them).
Anybody who tells you we understand the human nervous system with any sort of completeness or even with a coherent overarching theory suffers from microdeckia.
Never heard that one before. Had to look it up.
I diagnose that condition a lot. 
I’m a chronic pa]in patient and have been on everything from Vicodin to Fentynal. Eventually my doc settled on morphine with a Percocet for breakthrough pain. I am taking in the neighborhood of 90mg of morphine a day and it does a great job in taking my pain away, but it does nothing for new pain. Let’s say if I were to hit my hand with a hammer, I’d certainly feel it.
The other really strange thing is that it does absolutely nothing for certain kinds of pain. An example is tooth pain. The morphine was completely ineffective while I had great pain from a tooth that needed a root canal. However, plain old Tylenol worked like a charm. Go figure.
Funny how tylenol (acetaminophen) or nurofen (ibuprofen) has never worked for me. Only codeine and other strong pain killers. I also sometimes put EMLA cream (lidocaine/prilocaine) on a sore tooth and it helps.
My fathers friend has been given every type of pain killer known to man… and for whatever reason… these tiny canabis pills are the only thing that gives her comfort…swears by them.
The one time I took Oxy for a really bad migraine, it did not help.
I felt woozy, kind of dizzy and high, and still in pain.
First, I wouldn’t take any opioid before anesthesia. Good chance you may have an adverse reaction.
Same here. I had back pain and a friend gave me a half a pill of oxytocin. Within minutes the room started spinning, I literly crawled to my sofa and laid on my back. Whenever I tried to lift my head I felt like throwing up…never again.
When I was in the hospital they gave me morphine. What a worthless drug. After the injection I felt paralyzed, unable to move, yet I could still feel the pain. Just too numb to move. It’s in my medical file, no morphine, oxycodone, Percocet. I puke for days when any of those were given.
Due to the similar symptomology it is often misdiagnosed as cranial rectitis.
My dad’s like **obbn **- he takes Vicodin and has a Fentanyl patch. He still feels pain quite a lot. Those drugs seem to do nothing for his arthritis, for example.
Improperly, though. Everyone’s got a touch of microdeckia at times.