Pain Control After Surgery: Pain Medicines

People used to think they had to suffer through pain after surgery. But it’s normal to need medicine to control your pain. Different types of pain medicine are available, and your doctor can help you pick the right one. Some medicines, such as local anesthetics, are given before surgery to prevent pain. Other types, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids, are given after surgery to relieve pain. Opioids can be highly addictive and should be used following your doctor’s instructions.

Why is it important?

Treatment of pain can help you in the following ways:

  • It can make you feel more comfortable. This reduces stress and tension, which helps your body heal.
  • It can help you move better. If you feel less pain, you can start moving around or walking. This helps avoid problems such as bedsores, blood clots, and urinary infections.
  • It can lead to fewer complications. People whose pain is well controlled seem to do better after surgery. You can take deep breaths and be more active sooner. You are less likely to get sick with conditions such as pneumonia.

Path to improved health

Before surgery: Local anesthetics

What are local anesthetics, and when are they used?

Local anesthetics block the nerves that send pain signals to your brain. You may get them in a shot near your incision, through a small tube, or as a cream applied to your skin. A doctor (anesthesiologist) or nurse (nurse anesthetist) will give you this medicine before surgery.

What are the benefits of local anesthetics?

Local anesthetics only block pain in a specific part of your body. This means there are fewer side effects and risks. You may remain awake or be sedated. You are able to go home and return to your normal routine. Local anesthetics reduce your need for opioids.

What are the risks of local anesthetics?

You may be dizzy, weak, or confused after surgery. Local anesthetics often require several shots to make pain relief last. Too much of a local anesthetic can cause problems.

After surgery: Pain medicines

Many types of medicines can help with pain after surgery. Pills and liquids (oral medicines) are taken by mouth. Other types of medicines are given in your rectum (anal or suppository). Injections into your skin, muscle, or vein are another form.

What are the benefits of oral medicines?

There are many benefits to oral medicines. Pills and liquids work as well as shots and cause less discomfort. Plus, they’re often less expensive. Also, they’re easy to take when you go home from surgery.

What are the risks of oral medicines?

There’s a delay in pain relief with oral medicines. That’s because you have to wait for your body to absorb the medicine. It can be hard to take them if you’re nauseous or vomiting. (Some medicines come in rectal form so you can still take them.)

What are the benefits of injected medicines?

Pain medicine in injection form works even if you’re nauseous or vomiting. The medicine gets into your bloodstream quickly.

What are the risks of injected medicines?

The injection site often hurts for a short time. Side effects may include dizziness, headache, breathing problems, or seizures.

There are different types of injections.

  • Intravenous (IV) catheter. Medicine is injected into your vein through a small tube. The tip of the tube stays in your vein during recovery at the hospital. This method of pain relief works well for short-term pain.
  • Patient-controlled analgesia (PCA) pump. This is used in combination with an IV. A PCA pump lets you control when you receive pain medicine. If you feel pain, you push a button to inject medicine into your vein. Your doctor or nurse will show you how and when to use the pump. They program the pump so can’t overdose.
  • Epidural catheter. Pain medicine is injected into your back through a small tube. The doctor may inject medicine all at once or in small doses. This method works well for surgery on your chest or stomach. It is more complex and requires close monitoring to prevent problems.

NSAIDs

What are NSAIDs, and when are they used?

NSAIDs are used to treat mild pain after surgery. They reduce swelling and soreness. Examples of NSAIDs are aspirin, ibuprofen, and naproxen.

What are the benefits of NSAIDs?

Depending on your pain level, NSAIDs can stop or lessen pain. They prevent you from using stronger medicine, such as morphine. You can’t get addicted to NSAIDs.

What are the risks of NSAIDs?

NSAIDs may cause nausea, stomach bleeding, or kidney problems. Most NSAIDs thin your blood and can prevent blood clotting. They can increase your blood pressure and make your blood pressure medicine not work properly.

If your pain is too strong, your doctor may prescribe an opioid.

Opioids

What are opioids, and when are they used?

Opioids are stronger pain medicines. They most often are used for severe pain after surgery. Examples of opioids are morphine and codeine.

What are the benefits of opioids?

Opioids work well for severe pain. They do not cause bleeding in your stomach or other parts of your body. Your doctor will prescribe opioids only for extreme pain and only short-term.

What are the risks of opioids?

Opioids can cause drowsiness, nausea, constipation, or itching. They can affect urination and breathing. Many people become addicted to opioids. They can cause serious harm, including overdose and even death. It’s very important to use them as prescribed by your doctor.

Things to consider

Your doctor will help you decide how to control pain after surgery. The type and amount of pain medicine you need varies. It will depend on your overall health and what kind of surgery you have. Some pain medicines may interact with other medicines. Talk to your doctor about what medicines you take regularly before starting a new pain medicine.

Talk to your doctor about ways to manage chronic pain. He or she can help you create a plan that works without abusing pain medicine. There are pain management strategies you can try that do not include medicines. These include applying ice and/or heat to the area, acupuncture, and meditation and relaxation techniques.

Questions to ask your doctor

  • Do I need pain medicine before my surgery? If so, what kind?
  • What kind of pain medicine will I need after my surgery?
  • How long will I need to take pain medicine?
  • What should I do if I still have pain after finishing my medicine?

Resources

National Institutes of Health, MedlinePlus: Post Surgical Pain Treatment – Adults

U.S. Food and Drug Administration: Opioid Medications