Pain Relief Preoperatively and Postoperatively

Being a good patient does not mean being a silent one. If you have questions, problems, or concerns about the pain you may feel after surgery, let your caregiver know. Patients have the right to assessment and management of pain. The treatment of pain after surgery is important to speed up recovery and return to normal activities. Severe pain after surgery, and the fear or anxiety associated with that pain, may cause extreme discomfort that:

  • Prevents sleep.

  • Decreases the ability to breathe deeply and cough. This can cause pneumonia or other upper airway infections.

  • Causes your heart to beat faster and your blood pressure to be higher.

  • Increases the risk for constipation and bloating.

  • Decreases the ability of wounds to heal.

  • May result in depression, increased anxiety, and feelings of helplessness.

Relief of pain before surgery is also important because it will lessen the pain after surgery. Patients who receive both pain relief before and after surgery experience greater pain relief than those who only receive pain relief after surgery. Let your caregiver know if you are having uncontrolled pain. This is very important. Pain after surgery is more difficult to manage if it is permitted to become severe, so prompt and adequate treatment of acute pain is necessary.

PAIN CONTROL METHODS

Your caregivers follow policies and procedures about the management of patient pain. These guidelines should be explained to you before surgery. Plans for pain control after surgery must be mutually decided upon and instituted with your full understanding and agreement. Do not be afraid to ask questions regarding the care you are receiving. There are many different ways your caregivers will attempt to control your pain, including the following methods.

As needed pain control

  • You may be given pain medicine either through your intravenous (IV) tube, or as a pill or liquid you can swallow. You will need to let your caregiver know when you are having pain. Then, your caregiver will give you the pain medicine ordered for you.

  • Your pain medicine may make you constipated. If constipation occurs, drink more liquids if you can. Your caregiver may have you take a mild laxative.

IV patient-controlled analgesia pump (PCA pump)

  • You can get your pain medicine through the IV tube which goes into your vein. You are able to control the amount of pain medicine that you get. The pain medicine flows in through an IV tube and is controlled by a pump. This pump gives you a set amount of pain medicine when you push the button hooked up to it. Nobody should push this button but you or someone specifically assigned by you to do so. It is set up to keep you from accidentally giving yourself too much pain medicine. You will be able to start using your pain pump in the recovery room after your surgery. This method can be helpful for most types of surgery.

  • If you are still having too much pain, tell your caregiver. Also, tell your caregiver if you are feeling too sleepy or nauseous.

Continuous epidural pain control

  • A thin, soft tube (catheter) is put into your back. Pain medicine flows through the catheter to lessen pain in the part of your body where the surgery is done. Continuous epidural pain control may work best for you if you are having surgery on your chest, abdomen, hip area, or legs. The epidural catheter is usually put into your back just before surgery. The catheter is left in until you can eat and take medicine by mouth. In most cases, this may take 2 to 3 days.

  • Giving pain medicine through the epidural catheter may help you heal faster because:

  • Your bowel gets back to normal faster.

  • You can get back to eating sooner.

  • You can be up and walking sooner.

Medicine that numbs the area (local anesthetic)

  • You may receive an injection of pain medicine near where the pain is (local infiltration).

  • You may receive an injection of pain medicine near the nerve that controls the sensation to a specific part of the body (peripheral nerve block).

  • Medicine may be put in the spine to block pain (spinal block).

Opioids

  • Moderate to moderately severe acute pain after surgery may respond to opioids. Opioids are narcotic pain medicine. Opioids are often combined with non-narcotic medicines to improve pain relief, diminish the risk of side effects, and reduce the chance of addiction.

  • If you follow your caregiver's directions about taking opioids and you do not have a history of substance abuse, your risk of becoming addicted is exceptionally small. Opioids are given for short periods of time in careful doses to prevent addiction.

Other methods of pain control include:

  • Steroids.

  • Physical therapy.

  • Heat and cold therapy.

  • Compression, such as wrapping an elastic bandage around the area of pain.

  • Massage.

These various ways of controlling pain may be used together. Combining different methods of pain control is called multimodal analgesia. Using this approach has many benefits, including being able to eat, move around, and leave the hospital sooner.