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December 1963

Are Postoperative Narcotics Necessary?

Author Affiliations

Associate Professor of Surgery and Chief, Cardiac Surgery.; From the Department of Surgery, University of California Medical Center.

Arch Surg. 1963;87(6):912-915. doi:10.1001/archsurg.1963.01310180028007

The routine liberal administration of narcotics to the postoperative patient is a deeply rooted surgical tradition based on the erroneous impression that devastating pain is the inevitable consequence of a major surgical procedure. It is the purpose of this paper to assess the factors relating to pain in the postoperative period and to report an experience with a large consecutive series of surgical patients who have received (and required) either very small doses of narcotics or none at all.

From observations on laboratory animals and human infants (whose pain threshold has been demonstrated to be lower than that of adults1), it is notable that major pain and discomfort are rarely evident after surgical procedures. It is also well known that a person can sustain major tissue damage in war combat or in an athletic contest and yet continue in active motion with minimal discomfort, sometimes being completely unaware of

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