Pain Management

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.

With 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 activities sooner.

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:

• Concerns you have about medications
• Medications that have not worked well for you
• Allergies you have to any medications or drugs
• Side effects of pain medications that might occur
• Prescription and over-the-counter medications you take for other conditions
• The best way of administering pain medication for you

Pain medications are given in one of the following ways:

Upon request

You can ask the nurse for pain medicine as you need it.

Pain 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 under control.

Patient controlled analgesia (PCA)

You control the administration of the pain medicine by pressing a button to inject medicine through an intravenous tube in the vein.

Patient controlled epidural analgesia (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.

Your 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.

Postoperative pain relief medications

The 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 effects.

Some of the pain relief medications following surgery may include:

Nonsteroidal 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

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 rashes.

Local anesthetics

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

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.

Breathing and relaxation exercises can also help in controlling pain. Consult your physician for more information.