Pain Relief

Pain is common after surgery. Good pain relief is pre-set time limit important. It decreases suffering and it helps you recover more quickly. The aim to reduce your pain as you recuperate,

- so that it does not interfere with activities like rest and sleep.

- to help you with your physiotherapy and complete rehabilitation.

Some people need more pain relief than others. Worry increases the pain. Pain relief medications can be increased, given more often, or given in different combinations.

The nurse will ask you to score your pain between 0 - 10, both at rest and on movement. (0 = no pain, 10 = worst pain ever). This helps us assess the effectiveness of your pain relief.

GOOD PAIN RELIEF HELPS PREVENT COMPLICATION

- If you can breathe deeply and cough easily after your operation, you are less likely to develop a chest infection.

- If you can move around freely, you are less likely to get blood clots in your legs (deep vein thrombosis or DVT).

It is much easier to relieve pain if it is dealt with before it gets bad. So you should ask for your pain relief as soon as you feel pain and continue the treatment regularly.

Ways to relief pain

Pills, Tablets or Mixtures

These are used for all types of pain. They take at least half an hour to work and should be taken regularly. You need to be able to drink and not vomit for these medications to work.

INJECTIONS

These are often needed, and are given into a vein for immediate effect, or into your arm or thigh muscle.

Injections given into the muscle may take up to 20 to 30 minutes to work. Occasionally, we may give you an injection below the skin (sub-cutaneous).

SUPPOSITORIES

These waxy bullet-like pellets are placed in your back passage (anus). When the pellet dissolves the drug is absorbed into the body. They are useful if you cannot eat and drink or if you are likely to vomit. They are often combined with other methods of pain relief.

PATIENT CONTROLLED ANALGESIA (PCA)

PCA is a technique, which allows you to administer small amounts of pain relief using a machine, which is connected to your drip. When in pain, you need to press the button on the handset. A small amount of painkiller will go into your bloodstream to relief pain.

By using this method you are in greater control of your pain. There is no need to call a nurse if you are in pain.

However the nurses are there to help you at all times and you can call for assistance at any time.

You are very unlikely to overdose yourself as a result of using this machine. It is set such that once a safe amount of painkiller is delivered; no more can be given within a pre-set time limit.

To make the best use of your PCA it is advisable to press the button about 5 minutes before movement such a sitting up in bed, getting out of bed or deep breathing.

You can use as much or less as you want. But when the effect of the painkiller wears off you will need to keep giving yourself more doses to remain comfortable. Do inform the nurse if you feel any discomfort in your arm.

EPIDURAL ANALGESIA

The nerves from your spine and lower body pass through an area in your back close to your spine, called the 'epidural space'. The anaesthetist will inject local anaesthetics through a fine tube called an epidural catheter into this epidural space before your surgery. As a result the nerve messages are blocked and you will feel numb. The numbness will gradually subside. Epidurals can be used during and/or after surgery for pain relief.

Benefits of Epidural

- Better pain relief than other methods, particularly when you move.

- Reduced complications of nausea/vomiting, leg/ lung blood clots, chest infection and delayed bowel function.

- Quicker return to drinking, eating and full movement, possibly with a shorter stay in hospital.

Side effects though common are often minor and usually easy to treat. Serious complications are fortunately rare.

Your anaesthetist will discuss any possible side effects or complications with you prior to commencing the treatment.

• SPINAL INJECTION

The anaesthetist sometimes injects pain-relieving medication into the fluid filled sac which surrounds your spinal cord before the surgical procedure. It provides good pain relief for several hours.

Common Side Effect

Side effects of pain relief medications given through the spine, epidural space and muscle include:-

- Itchiness of the face and body

- Shivering

- Nausea (feel like throwing up)

- Vomiting

- Feeling sleepy

- Difficulty in passing urine

- Constipation

If you experience these side effects or any other discomfort please let the nurses know, so that they can help you.

Some people are worried about using morphine or morphine-like drugs as a painkiller. It is very rare for anyone to be addicted when using these drugs for pain relief for a short period.

On Discharge

Some pain following surgery is to be expected. It is not unusual to feel general aches and pains. Pain usually settles as the surgical wound heals. You may be given pain relief medicines to take home. At home, when you are feeling more comfortable, you may begin to reduce the dose and frequency of your pain medication. You are the only person who will know how much pain relief you require.