Pain control is an important part of your care after your operation. Good pain control can ease recovery. There are many ways to decrease pain after an operation. Pain medications can be given intravenously (through your IV), as an injection into your muscle, by mouth or infused into or near your spine. Some techniques used during an operation (such as epidural or spinal) also decrease post-procedure pain.
Patient Controlled Analgesia
The patient controlled analgesia (PCA) machine allows you to give your own pain medication. You will not have to call for your nurse when you have pain or want medication.
When you have pain, push the button and the machine will start. A small dose of pain medication will go into your IV. For your safety, no one except you should push this button.
Give yourself only enough medicine to take care of your pain. You should not ask the machine for a dose if you start to feel sleepy. Try to balance the pain relief against sleepiness.
Shortly after you push the button, your pain should begin to decrease. If you have pushed the button several times and your pain is not decreasing, tell your nurse.
An epidural is another way to control your pain after an operation. Your doctor or anesthesiologist can tell you if this is best for you. With an epidural, an anesthesiologist will place a tiny soft tube (epidural catheter) into your back. It is placed outside the space where your spinal fluid is. This soft tube is left in place after your operation and is used to control pain.
Pain medication will be delivered through the soft tube (catheter) continuously by a pump. The medication goes to your spinal nerves to relieve pain. You can also push a button to receive additional doses of medication. After a few days, pain is often easily controlled with intravenous medication or pain pills, and your catheter will be removed.
While you have an epidural:
- You will have a tube draining your urine (Foley catheter).
- Your nurse will check on you frequently.
- You may have oxygen.
- You must have help to walk. Please do not get out of bed without help from your nurse.
- Let your nurse know if you have pain, nausea or itching. Medications are available to treat these symptoms.
- Let your nurse know if you have weakness or numbness in your legs or if you feel light-headed or dizzy.
Although a spinal can be performed as the total anesthetic for an operation, it can also be used for pain control afterward. When a spinal is performed, medication is placed with a single injection into the space where your spinal fluid is located.
A femoral or interscalene nerve block is an effective method to control pain following knee or shoulder surgery. Local anesthetic is injected near the nerve allowing the joint to feel numb for approximately 10-16 hours following the injection. This significantly reduces the pain you may experience after surgery.
Depending on the type of surgery you have had your surgeon may insert a pain pump. A small catheter is placed near your procedure site. This connects to a small plastic pump. The pump automatically delivers pain medicine at a very slow rate. The pump is portable - it may be clipped to your clothing or dressing or placed in a small carrying case. Depending on the size of your pump, it may take two to five days to give all of the medicine.
Pain pills take about 30 minutes to start working. They will work best if taken prior to activity that may increase pain. If possible, take them with food.
Rating Your Pain
Whatever methods are used to control your pain, the nursing staff will ask you about your pain. You may be asked to describe your pain using a pain scale. This may be done in a number of ways including rating your pain from zero to 10. It is unrealistic to expect to have no pain after surgery. It is our goal to make your pain manageable.