Anesthesiologist Jonathan Hisghman, seen here during a recent surgical procedure at Medical Center of Trinity, says refined ways to anesthetizing surgical patients can lower opioid addiction risk.

TRINITY — The very thought of surgery instantly brings to mind one word: pain.

By its very nature, surgery is an unnatural shock to a human body, and pain is the aftermath of that shock.

Opioids have been commonly used as the major pain control for surgeries; however, the rampant abuse of those substances have given at least two local medical professionals reason to seek out and deploy a new method of surgical pain control that does not rely on the powerfully addictive chemicals that have become a plague on millions of lives in recent years.


Dilendra Weerasinghe, who performs general and bariatric surgery at Medical Center of Trinity, is attempting to reduce the problems with the use of opioid drugs to control pain associated with surgical procedures.

Dilendra Weerasinghe, a board certified general and bariatric surgeon, has now teamed with anesthesiologist Jonathan Hisghman, to offer patients surgery with opioid free anesthesia.

“The mainstay of anesthesia for at least 50 years have been narcotics,” Hisghman said. “The drugs we use now are substantially more powerful.”

Hisghman said the goal of the new protocol is to “capture all of the good effects opioids provide, such as removing pain and helping with relaxation, without any of the side effects.”

“The way we accomplish this is by hitting multiple receptors inside the body with multiple drugs instead of just one,” he explained. “We are just choosing to take a different pathway to accomplish the blocking of those pain fibers.”

Hisghman said the substances used with this method include magnesium, like someone can purchase over the counter. In this instance, it is given intravenously.

“We use that as one of our mainstays,” he said. “It kind of quiets down the nervous system. It quiets down the pain fibers.”

“The same part is we still observe all of the same safety precautions. We still monitor your heart rate, blood pressure, the amount of oxygen you’’re getting, you’re level of consciousness,” he said, “We still use propofol for inducing anesthesia.”

Gas anesthesia is still used in surgery but the sedation agents in use today are “extremely clean,” Hisghman added.

“It goes back to my roots,” Weerasinghe said. “I was trained in England. When I came here in 2005, there was a fundamental push to eliminate pain. People started prescribing opioids like crazy without looking at what it does in the long term.

“So, I had come in here looking at what a different strategy towards pain going through various levels of medication, and not using opioids as a knee-jerk reaction. We saw that opioids were really hurting our patients and not helping them.”

He said one study shows a bariatric surgery patient who was given the non-opioid protocol at six months has a seven percent chance of being put on opioids.

“The researchers concluded that if you eliminated every potential surgical complication which could potentially kill a patient, you could save 48 lives a year. Now, think of the numbers saved if they were not given that first prescription of opioids. There are 70,000 deaths which occur annually in this country on those who are around opioids.

“The doctor evaluated all of the current protocols and models, then cheery-picked the best of all of them,” Hisghman said. “This is what we stuck to and have been very diligent in making sure we stuck to it. It’s been very, very successful.”