Pain Management after Discharge from Hospital South Tyneside Anaesthetics Department and Acute Pain Services 1 Part of: South Tyneside and Sunderland Healthcare Group
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Information for patients This leaflet helps you to get the most from your pain medication when you leave hospital. It gives you advice on when to take your medication and how frequently to take it. Pain after your surgery You are ready for discharge, however your body is still healing and you may be experiencing pain. Remember after surgery it is normal to experience pain as part of the healing process. Taking pain medication regularly, at home, enables you to be in control of your pain management. Your pain medication will help you feel comfortable and allow you to move around, breathe deeply, cough and sleep. These things are very important after surgery to reduce the chance of further complications. It is important to take your pain medication regularly as prescribed for as long as you require them. How do I take my medications? You may have a combination of different pain medications; they work in different ways to give you the most effective and safest method of pain relief. It is important you take all medication that has been prescribed for you. You should not take any pain medication other than that prescribed. Before you leave hospital one of the pharmacists or your named nurse will explain your medications to you. You will be given a copy of your discharge letter when you go home from hospital, called Patient Discharge Summary (PDS). This includes notes for your GP (home doctor) with information about your treatment and current medication. 3
The label on your medicine box will tell you when to take them. A medication reminder chart can be provided by pharmacy if you require; you can discuss this with the pharmacist or your nurse prior to discharge. Some medicines have special instructions, such as take them before or after food, these instructions will be written on the label. The information below describes a variety of pain medications; you may be prescribed one of them or a combination: Paracetamol This is a very effective pain medication and well tolerated by most people. It should be taken every six hours but not exceeding the recommended dose. On its own it is good for mild to moderate pain. Even if you have stronger pain medication you should still continue to take paracetamol as its action helps the strong pain medication work more effectively. (Not to be taken with co-codamol as that already contains paracetamol). Anti-inflammatory medication These are medications such as Ibuprofen and Naproxen. They are very good in helping to reduce pain from inflammation. They can be taken with any of your other pain medication. They are intended for short term use (about two weeks). They should be taken regularly and you must not exceed the recommended dose. It is advisable to take these medications with food. 4
Codeine This comes in a range of different doses and you will have been prescribed the correct dose for you. Again, this should be taken regularly but not exceeding the recommended dose. It is good for moderate pain. Tramadol This is a strong pain medication and will be prescribed at a dose suited to your pain levels; it is good for moderate to severe pain. It should be taken regularly but you must not exceed the recommended dose. It is safe to take paracetamol at the same time as tramadol. Morphine/Oxycodone You may be prescribed morphine or oxycodone, these are very strong pain medications and will be prescribed at a dose to suit your needs and pain levels. These types of pain medications are prescribed for severe pain. Paracetamol is safe to take with either of these pain medications. Morphine Liquid / Oxycodone Liquid This is a liquid pain medication which is often used to top up your regular pain medication if you have break through pain before your next regular medication. This is sometimes referred to as rescue pain medication as it helps if pain suddenly increases. It is a strong pain medication and is safe to take with all other pain medication but you must not exceed the prescribed dose. 5
Side effects and cautions Paracetamol side effects are very rare but should be used with caution if you have liver disease Constipation is common when taking codeine, morphine or oxycodone (Refer to section below on constipation) Codeine, tramadol and morphine can all cause a dry mouth, sickness and sometimes drowsiness. These are not reasons to stop taking them but if these side effects become troublesome you should contact your GP for further advice. Do not operate machinery or drive if you experience drowsiness whilst taking these specific medications Anti-inflammatory medications should not be taken if you are allergic to Aspirin or if you have problems with your stomach, kidneys or have a history of asthma, and should always be taken with food. Constipation Some pain medications can cause constipation. Laxatives are often prescribed at the same time as your pain medications so that treatment for the constipation begins immediately. If you are not prescribed laxatives and need a laxative you can ask the nursing staff, medical staff and pharmacist for advice. Laxatives can be supplied with your pain medications when discharged from hospital. If constipation is caused by medication the condition will usually ease once you stop taking the medicine. However, you must not stop taking any prescribed medication unless your GP advises you to do so. Lifestyle changes can also help relieve constipation 6
A well-balanced diet high in fibre, including bran, fruit and vegetables is often helpful. Cutting down on white bread, cakes and sugar. Drinking at least 6 to 8 glasses of water a day. Hot beverages, such as coffee, tea or hot water, may help stimulate bowel movements. Prunes and plum juice can also be beneficial. Moving and carrying out exercises you have been shown by the physiotherapist can also help. Activity It is important to be as mobile as you are able to be. General moving around and walking will prevent further pain and stiffness. You may have been given some exercises to do whilst recovering from your operation; it is recommended that you start exercise 30 minutes after taking your pain medication. Pain following surgery should reduce over time; up to 6 weeks is an average time. You can reduce your pain medication during this time as you feel your pain levels reduce. Always follow instructions on your medication box/bottle and never exceed the recommended dose. 7
For more information or advice contact: Acute Pain Nurse Specialist - 0191 203 2906 (Monday to Friday 9.00am 4.00 excluding bank holidays) South Tyneside NHS Foundation Trust Harton Lane South Shields Tyne and Wear NE34 0PL Tel: 404 1000 You can also contact your GP or pharmacist For information about our Trust: www.stft.nhs.uk www.facebook.com/stnhsft/ @STFTrust We are committed to raising the standard of written information for patients, their carers, people who use the NHS and the general public. This information can be made available in another format or language on request. For further copies of this leaflet please contact on the telephone number above. Production date: Feb 2018 Author: Acute Pain Nurse Specialist Code: 0218/509 Review date: Feb 2021