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Printed at: 06:58:27 / 25-09-2021

Pain Relief After Surgery

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Produced by the Pain Management Team

Aims
Some discomfort or pain is to be expected after surgery. This will depend on the site and nature of the operation and will vary from person to person, but will reduce as healing takes place. During
an operation pain killing drugs will be given so that when you wake up from the anaesthetic in the recovery area you should be comfortable. However if you need any additional pain killers at this
stage, let the recovery nurse know, and the best option will be provided. In hospital you will be assisted by several health care professionals including doctors (for example anaesthetists and surgeons), nurses and physiotherapists.

Because of wide personal variation pain cannot be predicted according to the operation and it needs to be assessed individually.

Pain Assessment
To help asses your pain you will be asked to score to score your pain on a scale of 0 to 10.
0 – No Pain
5 – Moderate Pain
10 – Worst possible pain.

Pain Relief – Options
Pain killing medication forms the basis of most pain control. Before surgery, anaesthetists and medical staff will explain the most appropriate methods, which may include local anaesthetics given whilst you are asleep.

Common pain medications
1 Mild – Paracetamol
2 Moderate – Paracetamol + Codeine or Tramadol
3 Severe – Paracetamol + Codeine + Morphine

In addition you may benefit from Anti-inflammatory pain killers such as Diclofenac or Ibuprofen if you are able to take them.

Pain relief – How?
Pain killers can be given by:
• Mouth – to be swallowed
• Under the tongue – to dissolve
• Injection – into a muscle or under the skin
• Injection – into a vein
• Suppository – into the rectum
• Inhalation – eg gas and air
• Local anaesthetics or nerve blocks
• Patient Controlled Analgesia(PCA)
• Epidural injection in the back

Options for Major Surgery
The anaesthetist will advise about the most appropriate option, which may include:

• PCA (Patient Controlled Analgesia)
This provides you with a push button connected to a PCA pump which will deliver a small dose of pain killer (commonly Morphine) directly into your circulation via a small plastic cannula in your vein. This enables you to be in complete control of your own pain relief whenever you press the button. Overdosing is not possible because the pump is set to prevent this happening, but side effects can occur including sickness. If this happens ask for an anti-sickness treatment and consider reducing the frequency of pushing the button.

OR
• Epidural.
This involves an anaesthetist inserting a thin plastic tube through your back into the epidural space. Pain killing drugs are infused continuously through this tube to provide an anaesthetic numbing effect in the area of the operation. This method of pain control is more complex than others, and needs careful monitoring, but is very effective and widely used for pain relief in childbirth and for certain types of major surgery (For further information see information leaflet on Pain Relief for Major Surgery),

Side effects
Most painkillers and anaesthetics produce side effects. These are mostly minor, but many include sickness and vomiting, headache, dizziness, skin itching or other symptoms. Treatments are available to reduce these effects.

Local Anaesthetics
Some operations can be performed whilst you remain awake using a local anaesthetic to numb the affected area, without the need for a general anaesthetic. Local anaesthetics are also often given
during operations whilst you are asleep under a general anaesthetic. These may be injected into the operation wound area to provide better pain relief or they may be injected as a nerve block to numb a wider area.

Going home
You may need to take mild or moderate painkillers for a few days after returning home. You can either arrange these yourself in advance by providing over the counter pain killers (typically Paracetamol or Co-codamol and an anti-inflammatory such as Ibuprofen), or they can be prescribed by the hospital medical staff.

Questions
If you have further questions please ask a member of staff who will direct you to the most appropriate medical or nursing personnel.