(087) Use of Suzetrigine for Post-Operative Pain Management Protocol: Experience at a Single Site

Abstract Introduction To control post-operative pain, patients are prescribed a regimen that alternates over the counter (OTC) pain medications acetaminophen (1000 mg) with ibuprofen (600 mg) every three hours. When more potent pain relief is required, opioids have been traditionally utilized. Opioids act on the central nervous system (CNS) to bind to opioid receptors, blocking central pain signals. Opioid use, however, is associated with toleration, dependency and compulsive, addictive drug-seeking behavior. On January 30, 2025, the Food and Drug Administration approved the oral, non-opioid suzetrigine (Journavx) for the treatment of moderate-to-severe acute pain in adults. Suzetrigine controls pain by blocking the sodium channel NaV1.8 in the peripheral nervous system thus preventing pain signal transmission to the CNS. Since suzetrigine acts only at the peripheral pain source and not on the CNS, it is non-addictive. Objective This study examined our patients’ self-reports of side effects and benefits of suzetrigine for post-operative pain control used concomitantly with OTC pain meds, with or instead of the opioid oxycodone. Methods Post-operatively patients are regularly queried as to which pain medication(s) were used, dose and timing, side effects experienced, and whether these treatments were successful in ameliorating pain. This study focused on reviewing this data collected at least one month post-operatively as of June 1, 2025. Results A total of 9 women responded to the queries regarding pain control after surgery; 4 (44%) complete vestibulectomy with vaginal advancement flap; 3, (33%) complete vestibulectomy with buccal mucosa graft; 1 (11%) partial vestibulectomy; and 1 (11%) dorsal slit surgery. All 9 used suzetrigine post-operatively for a mean of 11 days (range 4–15). Five (55%) started acetaminophen/ibuprofen before using suzetrigine; the mean use was 16 days (range 7–25). Six (66%) patients used the opioid oxycodone for 6 days (range 2–10). Thus, while on suzetrigine and OTC pain medications, opioids were needed only 51% of the time. Seven of the 9 (78%) patients felt using suzetrigine to be moderately to very successful. The most common adverse events were itching (mild n = 3, 33%, severe n = 1, 11%) and mild rash (n = 2, 22%). Other side effects included muscle spasms, constipation, and nausea experienced by one patient each. Eight of 9 (88%) were willing to use suzetrigine again except for 1 who experienced multiple adverse reactions and syncope several days later; based on the timing it is unknown whether these side effects were related to suzetrigine use. Eight patients (89%) recommended the use of suzetrigine for future surgery patients and 4 of 5 (80%) expressed gratitude that suzetrigine replaced or decreased the need for opioids post-operatively. Conclusions In our post-operative patient cohort, suzetrigine was used for 11 days post-operatively with minimal side effects, while an opioid was only used for 6 days. Thus, suzetrigine reduced the need for post-operative pain relief with opioid by approximately 50%; prior to suzetrigine, an opioid would have been predictably needed for the full 11 days. This is the first report regarding the low side effect profile and high benefits of suzetrigine for post-operative pain control for sexual medicine surgeries. Disclosure No.