POST-OP PAIN MANAGEMENT You re Part of the Team
Pain Management After Surgery Having a procedure or surgery to address a health issue can result in post-op (postoperative) pain. This pain can and should be controlled. Good pain control will help you feel more comfortable and heal faster. As you recover, tell your healthcare team when you re in pain, how bad it is, and what makes it better or worse. Then help your team find the painrelief methods that work best for you. Pain Is Real Pain is vital. It helps protect your body by alerting you to problems so they can be addressed. Pain is expected after most surgeries. Different surgical procedures cause different types of pain. Also, everyone feels and reacts to pain differently. So don t compare your pain with what others feel or think you should feel a certain way. No matter how your pain feels, it can be managed. Benefits of Pain Control When post-op pain is managed, recovery is often faster. Pain medicines allow you to sit up or even walk within hours of surgery. This helps reduce surgical risks, such as blood clots and pneumonia. In addition, less pain means less stress on the body and the mind. Put these benefits together and they can add up to a shorter hospital stay, fewer problems after surgery, and a faster recovery. 2
Short-term use of pain medicines is not addicting. So don t be afraid to take these medicines when you need them. Your Role in Pain Relief Your healthcare team will prescribe and deliver pain medicines and other measures to control your pain. But you re the only one who can tell how well they are working. Be honest when your healthcare provider asks how you re feeling. If pain is not being reduced, say so. Don t act brave or worry about being a bother or complainer. You have a right to pain control! Medicines can be adjusted to meet your needs. Finding what works for you is what really matters. 3
Communicating Your Needs Before surgery, you ll be asked questions to help determine the best pain management plan for you. Be sure to mention what medicines you take and what health problems or allergies to medicines you have. Also mention any beliefs you have about pain. Each of these can affect your care. After surgery, you will likely use a tool such as a pain scale to help describe the level of your pain. Describe Your Pain Level A pain scale is a tool used to describe and monitor pain level. Above is an example of what a scale might look like. If 0 means no pain, and 10 is the worst pain possible, how would you rate what you feel? You may be asked to use the scale every few hours to help make sure your pain is controlled. Note that you may feel some pain, even with medicine. Still, speak up if the medicine does not reduce your pain or if pain suddenly increases. Keep to a Schedule After surgery, pain medicines may be given on a regular schedule or when the patient asks for them. Ask your healthcare provider how often you can have pain medicine. Medicines take time to work. So unless your pain level is near 0, ask for your next dose before the last one wears off. If you miss a dose and the pain gets bad, extra medicine may be needed to manage the pain. And even with a higher dose of medicine, you may not reach the best level of relief. Mention Pain Triggers You may find that certain movements make you hurt, such as getting out of bed. Or pain may get worse at the end of the day. Tell your doctor or nurse about any pain triggers that you notice. If needed, your treatment can be adjusted to keep you more comfortable. 4
Medicines for Pain Post-op pain may be controlled with different types of medicines. The goal is to provide pain relief for as long as possible with the least amount of medicine. This helps reduce unwanted side effects. Types of pain medicines you may be given are listed below. Local Anesthetics These medicines are often injected or given with a patch. They temporarily block nerves in a part of your body. This relieves pain. Side effects of these medicines may include low blood pressure, muscle weakness, and numbness. Analgesics These pain relievers may be given by IV line or taken by mouth. Unlike local anesthetics, these medicines affect the whole body. Opioids. These are the most common medicines used to control post-op pain. They can control even severe pain. NSAIDs (nonsteroidal anti-inflammatory drugs). These contain no opioids. They help control pain and swelling. Prescription-strength NSAIDs may be used alone or with opioids. Aspirin and ibuprofen are low-dose NSAIDs that can be bought over the counter. Acetaminophen also contains no opioids. It may be given to help relieve post-op pain in certain cases. It may be used alone or with opioids. Other Medicines In addition to pain relievers, these medicines can help increase your comfort. Antianxiety medicines can help pain medicines work better. Muscle relaxants may be given to loosen tense muscles. Sedatives make you feel relaxed and sleepy. Antiemetics help reduce nausea and vomiting. They may also make you sleepy. 5
Medicine Delivery Methods Pain medicines can be given in several ways. The method depends on the surgery, how much pain you re feeling, and your phase of recovery. The methods include strong medicines to relieve pain during and right after surgery. Near the end of your hospital stay, you ll likely be switched to oral pain medicines. You may be given a prescription for pain-relieving pills or liquids to take at home. Injections Medicine can be injected for overall pain relief or to relieve pain in a specific area. Injections of local anesthetic can relieve pain around the injection site. A regional anesthetic or a nerve block delivers medicine directly onto a main nerve. This blocks pain signals from a specific part of the body. Spinal anesthetic is an injection of medicine into the fluid around the spinal cord. This blocks pain from the waist down. IV (Intravenous) For pain relief within minutes, an IV line may be used. An IV line is put into a vein in the hand or arm. It delivers medicine directly into the bloodstream. Pain medicine may be injected into the IV tubing on a schedule or as needed. Or an IV may deliver a slow, continuous supply of pain medicine. In some cases, the IV is connected to a pump that you can control yourself. This is called a PCA (patientcontrolled analgesia) pump. You press a button to get a safe dose of medicine. PCA pumps may be used alone or along with continuous IV pain medicine. 6
Epidural An epidural provides ongoing medicine for pain relief. It is often used during and after childbirth, joint surgeries, or surgeries in the chest or abdomen. Pain medicine is fed through a soft tube (catheter) into the low back around the spinal cord. Opioids alone or both opioids and anesthetics may be used. Oral Medicines Pain medicines can be given by mouth. They can be pills, liquids, and even sweetened lozenges. Some are swallowed. Others are allowed to dissolve in the mouth. If you are using an injection, IV, or epidural, you will likely be transitioned to oral medicine before you leave the hospital. Relax to Reduce Pain Pain medicines work better when you re relaxed and signals of fear and anxiety aren t flooding the brain. Each of the techniques below can help. Positioning. Lie or sit so you are comfortable and can breathe easily. Deep breathing. Breathe in slowly for a count of 3 then out for a count of 3. Repeat as you focus on your body relaxing. Distraction. Listen to an audiobook or to soft music. Visualization. Picture yourself in a relaxing place, such as on a warm beach or floating on a cloud. Then, picture your pain separating from you. Maybe imagine it drifting away or being sealed up in a box. 7
Also available in Spanish TAKE OUR PATIENT SURVEY. Help us help other patients. Please visit www.kramesurvey.com to provide your feedback on this booklet. This booklet is not intended as a substitute for professional medical care. Only your doctor can diagnose and treat a medical problem. 2016 The StayWell Company, LLC. www.kramesstore.com 800.333.3032 All rights reserved. Made in the USA. Managing Pain at Home Once you re home, continue to take steps to manage your pain. For the best pain relief possible: Use your medicine as directed. Take it on schedule, before pain gets bad. It may help to write down when you take each dose so you don t lose track. Keep in mind that medicines need time to work. Most oral pain relievers need at least 20 minutes to take effect. After taking your dose, wait about 30 minutes before starting an activity that may be painful (such as dressing). Do not drive or use dangerous machines or power tools while you re taking pain medicines. Call your healthcare provider if your pain is not relieved, if pain gets worse, or if you have bothersome side effects. 12265 1512