Pain control after surgery
Pain is your body's way of telling you something is wrong.
It is normal to expect a certain amount of pain following surgery;
however, if pain does not subside with pain medication, there may be a
more serious problem. Your physicians and nurses will ask about your pain
because they want you to be comfortable. It is important that they be
alerted if their efforts to control your pain are not effective.
today's new and improved pain medications, there is no reason for anyone
to tolerate severe pain. By effectively treating pain, you will heal faster, have fewer
complications following surgery, and be able to go home and resume normal
importance of discussing
pain control before your surgery:
Discuss pain control options with your physician before you have surgery.
Talk about pain control methods that have worked well, or not worked well
for you in the past. Also,
discuss the following with your physician:
you have about medications
that have not worked well for you
you have to any medications or drugs
effects of pain medications that might occur
Prescription and over-the-counter medications you take for other conditions
medications are given in one of the following ways:
You can ask the nurse for pain medicine as you need it.
pills or shots given at set times
Instead of waiting until you experience pain, you are given pain
medicine at certain, regular times throughout the day to keep the pain
controlled analgesia (called PCA)
You control the administration of the pain medicine by pressing a
button to inject medicine through an intravenous tube in the vein.
controlled epidural analgesia (called PCEA)
This type of administration provides continuous pain relief. A tube is
inserted in the spine, and when you press a button, the pain medicine
goes into an epidural tube, which is inserted in the back.
physicians and nurses will want to know how your pain medicine is working
and whether or not you are still experiencing pain. The physician will
change the medicine, and/or dosage, if necessary.
What are the
different types of pain relief medications commonly used after surgery?
amount of post-operative discomfort depends on various factors,
particularly the type of surgical procedure you have undergone and your
threshold for pain. Discuss your pain management options with your
physician, including the various types of pain medications and their side
of the pain relief medications following surgery may include:
anti-inflammatory drugs (NSAIDs)
Some examples of this type of medication are aspirin and ibuprofen
(i.e., Advil and Motrin). These medications are most often used for
mild or moderate pain. NSAIDs carry no risk of addiction, and
depending on the amount of pain, they may eliminate the need for
stronger medications. NSAIDs, however, may interfere with blood
clotting and may cause nausea, vomiting, or kidney problems.
Opioids include drugs such as morphine and codeine, which are most
often used for acute pain, and may be given immediately following
surgery. Contrary to popular belief, it is rare for a patient to
become addicted to opioids following surgery. Opioids may cause
dizziness, nausea, vomiting, constipation, or itching and other skin
and relaxation exercises can also help in controlling pain. Consult your
physician for more information.
More than 100 drugs are available for local anesthesia. These drugs
act by blocking the transmission of nerve impulses and are often
administered for severe pain in a limited area of the body, such as
the incision site. Several injections may be necessary to control the
pain, and too much anesthetic can have various side effects.
Acetaminophen (i.e., Tylenol) is one type of pain reliever that is
unlikely to cause the stomach irritation that may be associated with
aspirin, naproxen sodium, ketoprofen, and even ibuprofen, the active
ingredients found in some other nonprescription pain relievers.
Certain acetaminophen products may also be less likely to interact
with other medications you may be taking. Use of all types of pain
relievers is not recommended, unless directed by your physician.
I've often thought that it'd be nice if the pain "contract" were bilateral
for occasions such as the one you are asking about.
Chronic pain patients have almost no chance of getting what they need after
surgery because the people in the hospital "disapprove" of what pain patients
are already getting, going in.
As you might note re the doctor who wrote recently to the list wondering
about giving Naltrexone during anesthesia, the patient's safety is not the
first thing on the minds of many people working in medicine.
Shocking but true.
At the very least, I'd contact the patient advocate before going in and bring
the JCAHO number with you, displayed prominently so the docs and nurses can
see you have it. Don't be afraid to use it.
If you want to be even more aggressive, and risk drawing the wrath of the
hospital staff, write a letter to all concerned, way before the surgery,
being specific about just what kinds of doses may be required, stating that
you expect to be given what you need and that your pain will be treated in
accordance with JCAHO principles. Ask them to write you back giving you
written assurance that they will comply. If they refuse, ask for that in
writing and send it to JCAHO.
Contact JCAHO by either calling:
1-800-994-6610 Fax: 1-630-792-5636
Or Write To:
If you file a complaint with JCAHO, one of the following actions will be taken:
Incorporate in monitoring database.
Review complaint at next survey.
Ask organization to provide written response.
Conduct unannounced on-site evaluation.
Go as high up as you need to and get written assurances before you agree to surgery...because once they've got you, they've got you.