Serving Chili Peppers (sort of) to Patients Undergoing Knee and Hip Replacement Surgery to Reduce Post-Surgical Pain

Researchers are “hot” on the trail to finding a new way to decrease post-surgical pain following painful operations such as knee and hip replacements. Surgeons are experimenting by dripping capsaicin – the ingredient that gives chili peppers their fire, directly into open wounds during knee replacement surgeries hoping that bathing surgically exposed nerves in a high enough dose will numb them for weeks. The theory takes root from the fact that when you bite into a hot pepper, after the initial burn your tongue goes numb.

Research shows that capsaicin targets key pain-sensing cells in a way that blocks pain but does not impair other nerves responsible for functions such as movement. Its effects also last relatively long, thus reducing the need for morphine and other narcotics following surgery. In a pilot program of 50 knee replacements, the half treated with capsaicin used less morphine in the 48 hours after surgery and reported less pain for two weeks as compared to the half treated with a dummy solution. The benefits include that it is a one-time dose, works inside the wound rather than the whole body, and does not tether a patient to an IV when beginning physical therapy. Larger doses in more patients are ongoing.

The advantages of the more focused pain relief from capsaicin are being applied to attempts to develop epidurals that would not confine women to bed during childbirth, dental injections that don’t numb the whole mouth, and pain relievers to treat the intractable pain of cancer patients. Testing has also been done on men who underwent hernia repair, in which capsaicin recipients reported significantly less pain in the first three days after surgery.

General and local anesthetics work by interfering with the excitability of all neurons, not just pain-sensing ones. Advances using capsaicin could reduce the dramatic side effects of general and local anesthetics, that is loss of consciousness in the former and temporary paralysis in the latter.

Chili peppers have been part of folk remedy for centuries. It is interesting that this advancement in pain management brings people back to more natural remedies.

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