Pain relief after surgery Imprtant infrmatin fr patients www.mchft.nhs.uk We care because yu matter
This leaflet is designed t help yu cntrl any pain yu may have at hme fllwing yur peratin. Please read this leaflet carefully and shw it t the persn wh is lking after yu. This leaflet is nt intended fr thse wh are pregnant r breastfeeding. Yur painkillers have been prescribed fr yu and shuld nt be shared with anyne fr any reasn. Yur peratin, age and medical cnditins will have been taken int accunt befre prescribing any painkillers. Pain after surgery is nrmal, the extent and duratin f any pain will be dependent n the type f surgery yu have had. This leaflet cntains infrmatin t help yu keep the pain as mild as pssible. A cmbinatin f painkillers usually prvides effective pain relief and reduces the likelihd f side effects like nausea, sedatin and indigestin. We recmmend that sme f yur painkillers are taken regularly and sme are taken as and when needed (rescue). When taking the painkillers described in this leaflet, yu shuld nt take any ther painkillers unless yu have clarified this with yur nurse, dctr r pharmacist. If yu take aspirin fr bld thinning yu shuld cntinue t take these. If in dubt, check. What t d if I am in pain? Take yur painkillers regularly. D nt wait fr the pain t becme severe; mild pain is easier t cntrl. Yur painkillers will be mre effective when taken thrughut the day. Assess yur pain at least fur times a day, fr example at breakfast, lunch, teatime and bedtime. Hw d I assess pain? Ask yurself is the pain nne, mild, mderate r severe. It is rare t have n pain after surgery but, if yur pain is mre than mild (including when yu mve), yu shuld cnsider taking mre painkillers but remember t stay within the prescribed dses. 1 Yur painkillers Paracetaml is used t prevent and treat mild t mderate pain and t reduce yur temperature.
It can take up t an hur t take effect. Paracetaml is exceptinally safe in nrmal dses. The dse is 1g (tw 500mg tablets), which can be taken every 4-6 hurs. NO MORE THAN the recmmended maximum dse f 8 tablets (4 grams) a day must be taken. If yu take mre than the recmmended dse f paracetaml please seek urgent help. Never take with ther medicines that cntain paracetaml, e.g. C-Cdaml, C-Dydraml, Tramacet, cld and flu remedies. We recmmend taking paracetaml regularly fr at least 3 days after surgery and then either as a rescue painkiller r regularly depending n hw well yur pain is cntrlled. Nn-steridal anti-inflammatry drugs (NSAIDs) Ibuprfen is classed as a NSAID. These medicines are especially gd fr treating pain after surgery and muscular, jint and bne pain. It may take between 1-2 hurs fr the medicine t start wrking. The medicine shuld be swallwed whle with a drink f water and nt chewed as they have a prtective cating. It is imprtant t take these drugs with r after fd. Side-effects may include stmach irritatin, sickness, diarrhea and stmach ulcers r bleeding. Anti-inflammatry painkillers can make asthma wrse but mst peple with asthma are nt affected. The usual dse is 400 mg taken every 6-8 hurs (n mre than 3 dses in 24 hurs). We recmmend taking ibuprfen regularly fr at least 2 days after surgery, then as a rescue painkiller rather than regularly. Naprxen is anther NSAID. Its side effects are the same as ibuprfen (see abve). It may take between 1-2 hurs fr the medicine t start wrking. The medicine shuld be swallwed whle with a drink f water and nt chewed as they have a prtective cating. It is imprtant t take these drugs with r after fd. The usual dse is 500 mg every 12 hurs (tw dses in 24 hurs). We recmmend taking naprxen regularly fr at least 2 days after surgery then as a rescue painkiller rather than regularly. 2
Rescue painkillers Cdeine is a weak piid (i.e. a weak mrphine based drug) and is used t treat mderate t severe pain. Cdeine can take up t an hur t have sme effect n yur pain. Side-effects may include drwsiness, feelings f sickness, prblems passing urine and cnstipatin. Less cmmnly it can cause cnfusin and rarely hallucinatins. Lying dwn may help t relieve the feelings f sickness. The feelings f drwsiness and sickness shuld wear ff as yur bdy gets used t the medicines. Drinking mre fluids and eating mre fruit and vegetables may treat cnstipatin; yu may als need t take laxatives. The usual dse is 30 60 mg (1 2 tablets) up t fur times a day. Leave at least a fur hur gap between each dse. Yu shuld nt drive r perate machinery if yur thinking is affected r the painkiller makes yu feel sleepy. Yu shuld avid alchl whilst using these tablets. Dihydrcdeine is anther weak piid used t treat mderate t severe pain. Dihydrcdeine can take up t ne hur t have sme effect n yur pain. The side effects are the same as cdeine. The usual dse is 30 mg (1 tablet) up t fur times a day; leave at least a fur hur gap between each dse. Yu shuld nt drive r perate machinery if yur thinking is affected r the painkiller makes yu feel sleepy. Yu shuld avid alchl whilst using these tablets. Tramadl cmbines sme mrphine-like effect with a painmdifying effect and is used t treat mderate t severe pain. Tramadl can take up t ne hur t have sme effect n yur pain. Side effects are the same as fr cdeine and dihydrcdeine. The usual dse is 50 100 mg (1 2 capsules) up t fur times a day; leave at least a fur hur gap between dses. Yu shuld nt drive r perate machinery if yur thinking is affected r the painkiller makes yu feel sleepy. Yu shuld avid alchl whilst using these tablets. 3
Fllwing discharge frm hspital yur next dse f painkillers can be taken at: Paracetaml: Day... Date... Time... NSAID: Day... Date... Time... Rescue: Day... Date... Time... Yur nurse will place a tick next t the painkillers yu have been given (pages 1 3) and cmplete the time yu can have yur next painkiller abve. Yur nurse will prvide cntact numbers n the back page fr yu t use if yu experience any prblems. Please check that these have been cmpleted befre yu leave the hspital. Keeping a recrd Use the chart belw t help yu keep a recrd f the painkillers yu have taken. Fill in the time, yur level f pain and the number f tablets / capsules taken. Number f tablets / capsules taken My pain scre is; Time nne, mild, mderate, Paracetaml NSAID Rescue severe. Day ne Day tw Day three Day fur 4
Imprtant phne numbers If yu have any prblems with persisting pain r sickness please cntact: Treatment Centre... Ward... GP... Fr medicines related enquiries, please cntact Medicines Infrmatin n 01270 273221 Mnday t Friday, 10 am t 3 pm. Finally Remember that pain after surgery is nrmal but using the painkillers as prescribed will help t reduce this pain and imprve yur recvery. Ensuring yur pain is kept t a minimum shuld allw yu t get mbile and return t nrmal activities. If the medicines yu are taking d nt cntrl yur pain cnsider if; Yu are getting enugh rest Yu have elevated the affected part f the bdy and cled apprpriately (dependent n peratin) Yu are taking the painkillers as suggested If yu require mre painkillers yu can btain paracetaml and ibuprfen ver the cunter frm yur lcal chemist. Naprxen, cdeine, dihydrcdeine and tramadl will need a prescriptin frm yur GP. This leaflet is available in audi, Braille, large print and ther languages. T request a cpy, please ask a member f staff. Reviewed by Readers Panel March 2016. Reprinted Nvember 2017 Review Nvember 2019 Ref: WHD310/1117