Pain Control After Surgery: Pain Medicines
What are the benefits of taking pain medicine after surgery?
People used to think they just had to suffer through severe pain after surgery. Today, your nurses and doctors can do many things before and after surgery to prevent or relieve your pain. Treatment of pain can help you in the following ways:
Many types of medicines are available to help control pain. Some of these include nonsteroidal anti-inflammatory drugs (called NSAIDs), opioids and local anesthetics.
- You can feel more comfortable, which will help your body heal.
- You can get well faster. If you feel less pain, you can start walking and get your strength back more quickly. You may even be able to leave the hospital sooner.
- You may have fewer complications after surgery. People whose pain is well controlled seem to do better after surgery. For example, they don't have as many problems, such as pneumonia and blood clots
When are NSAIDs used?
For mild pain after surgery, you might be given NSAIDs. These medicines reduce swelling and soreness, and relieve mild to moderate pain. Some examples of these medicines are aspirin, ibuprofen (two brand names: Advil, Motrin) and naproxen (one brand name: Aleve).
What are the benefits of NSAIDs?
You won't get addicted to these medicines. Depending on how much pain you have, these medicines can take it away or at least lessen your need to take a stronger medicine, such as morphine.
What are the problems with NSAIDs?
NSAIDs may cause nausea, stomach bleeding or kidney problems. Most NSAIDs interfere with blood clotting, and they can also make high blood pressure worse and affect the way blood pressure medicines work. If your pain is strong, you will usually also have to take an opioid to relieve it.
When are opioids used?
Opioids (such as morphine and codeine) are the medicines most often used for acute pain, such as short-term pain after surgery.
What are the benefits of opioids?
Opioids work well for severe pain. They don't cause bleeding in the stomach or other parts of the body. It's rare to become addicted to an opioid after surgery if it's used as prescribed by your doctor.
What are the problems with opioids?
Opioids may cause drowsiness, nausea, constipation or itching. They can also interfere with breathing or urination.
What about local anesthetics?
Local anesthetics (such as procaine) can be given in a shot near your incision or through a small tube in your back. These medicines block the nerves that send pain signals to your brain.
What are the benefits of local anesthetics?
Local anesthetics will block pain only at that area of the body. There is little or no risk of drowsiness, constipation or breathing problems when you use a local anesthetic. Local anesthetics reduce your need for opioids.
What are the problems with local anesthetics?
Several shots are usually needed to make pain relief last, but too much of a local anesthetic can cause problems. Even average doses may cause you to feel dizzy or make your legs feel weak.
How is pain medicine given?
Medicines can be given by mouth (liquid or pill), through the rectum (suppository) or injected into the skin, muscle or vein.
What are the benefits and problems of oral medicines?
Aspirin, ibuprofen or codeine can be taken by mouth. Pills and liquids cause less discomfort than shots into a muscle or the skin. They can work just as well as shots. They are inexpensive and easy for you to take when you go home from the hospital. On the other hand, these medicines can't be used if you aren't supposed to take anything by mouth or if you're nauseated or vomiting. (Some of these medicines also come in a rectal suppository, so you can take them even if you're nauseated.) There may be a delay in pain relief with oral medicines, because you have to wait for your body to absorb the medicine.
What are the benefits and problems of injected medicines?
Medicines given in shots into the skin or a muscle can work even if you're nauseated or vomiting. However, the injection site usually hurts for a short time.
Pain relief medicines can be injected into a vein through a small tube called an intravenous (IV) catheter. The tip of the tube stays in your vein all the time that the medicine is being used. Medicine given this way goes through your body fast, so it starts to work quickly. This method of pain relief works well for brief pain.
With a patient-controlled analgesia (PCA) pump, you can control your own doses of pain medicine. When you begin to feel pain, you push a button to inject medicine into your vein; a small tube must first be put into your vein. If you use the PCA pump, you have to learn how and when to use it.
Pain medicine can also be put into your back through a small tube called an epidural catheter. This method works well when you're having surgery on your chest or your stomach. It takes a specially trained doctor (called an anesthesiologist) to put the small tube in your back. This person also watches you for problems that can happen several hours after the pain medicine is given.
- Adapted from Pain Control After Surgery: A Patient's Guide. AHCPR Pub. No. 92-0021. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, 1993.
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.