Postoperative pain relief
Pain that occurs after surgery is an important issue. Before the surgery took place, you hopefully discussed with your surgeon about how much pain you should expect and how it will be managed.
Several factors can determine how much pain you have and how easy it is for you to manage it.
Besides keeping you as comfortable as possible after surgery, controlling your pain is important for your recovery. Good pain control is needed so you can get up and begin to move around. This is important because:
There are many types of pain medicines. Depending on the surgery and your overall health, you may receive a single medication or a combination of medications.
Studies show that patients who use pain medication after surgery to control their pain often end up using fewer painkillers overall than those who avoid pain medication.
As a result, your job as a patient is to tell your doctors and nurses when you are having pain and if the medicines you are receiving control your pain. While the nurses and doctors around you will always be busy, do not worry about bothering them. In the end, only you can decide which type of pain relief works best.
Right after surgery, you may receive pain medicines directly into your veins through an intravenous line (IV). This line runs through a pump that will be set to give you a certain amount of pain medicine.
Often, you can push a button to give yourself more pain relief when you need it. This is called patient controlled anesthesia (PCA) because you are the one who manages how much extra medicine you receive. However, it is programmed so you cannot give yourself too much.
Epidural pain medicines are delivered through a soft tube (catheter) that is inserted into your back into the small space just outside the spinal cord. The pain medicine can be given to you continuously or in small doses through the tube.
You may come back from surgery with this catheter already in place. Or a specialist physician or anesthesiologist will insert the catheter into your lower back while you lay on your side in your bed.
While rare, some risks associated with epidural blocks include:
Narcotic pain pills taken by mouth or shots given into your muscle may provide enough pain relief. You may have pills or shots right away after surgery. More often, you will receive this medicine when you no longer need epidural or continuous IV medicine.
Ways you receive pills or shots include:
Most pills or shots will provide relief for 4 - 6 hours, or more. If the medicines do not manage your pain well enough, ask your health care provider about:
Sherwood ER, Williams CG, Prough DS. Anesthesiology principles, pain management, and conscious sedation. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 18.