There is good evidence to show that when pain following an operation is well controlled, you recover more quickly. When you come into hospital your nurse can discuss the various types of pain control appropriate for you. The final decision as to what form of pain control you receive, will be made by your anaesthetist after consultation with you.
After your operation your nurse will frequently ask you if you have any pain and advise on appropriate treatment, to make sure that you are as comfortable as possible. There is no need to suffer anything more than slight pain, even after major surgery; and indeed severe pain may impair your recovery, so do not suffer in silence.
During your hospital stay you may be visited by a member of the Acute Pain Team whose aim is to ensure that all patients receive the best pain control possible. A member of the Acute Pain Team is available for advice 24 hours a day.
Types of Pain control
Painkillers work most effectively if given on a regular basis to prevent anticipated pain, rather than waiting for pain to become so severe that something stronger is needed to treat it at a later stage.
In general, the treatment of your pain after surgery will be based on one or more of the following:
Non-steroidal anti-inflammatory drugs (NSAIDs)
For example: paracetamol, ibuprofen (Nurofen), diclofenac. These drugs can be very effective when administered alone for mild to moderate pain, or in combination with other drugs for severe pain. They can be given in tablet form, as a suppository or an injection. Some people are unable to tolerate this form of medication.
Benefits: NSAIDs provide effective pain relief for mild to moderate pain, without making you sleepy and cause less nausea and vomiting than morphine-like drugs. They reduce or eliminate the need for stronger painkillers.
Risks: Most NSAIDs, apart from paracetamol, interfere with blood clotting. They may cause nausea, stomach irritation and kidney problems, or worsen asthma in some people.
Patient Controlled Analgesia
Analgesia means pain relief. Patient Controlled Analgesia, or PCA, s a system which allows you to give yourself small quantities a morphine when you require it. This means that you are in control of how much pain medication you receive and when you receive it, as only you know how much pain you are in.
How does PCA work?
You will be connected to a machine, which is usually attached to a drip stand. When you press the control button a small dose of morphine is injected into a small drip in your arm.
You will not feel the injection, but you should feel the benefit of it within a few minutes.
The device will not give you another dose for at least 5 minutes, even if you press the control button, therefore preventing you from overdosing yourself.
If you are still in pain after waiting for 5 minutes for the medication to take effect then press the control button again. This process can be safely repeated throughout the day, enabling you to remain comfortable.
After your PCA machine s discontinued you may still require pain relief, which can be given in the form of tablets or suppositories.
You will not become addicted to morphine as a result of using this machine for a short period 0f time following your operation.
NB: PCA is safe providing that you are the only person to press the control button, as only you know if you need it. Do not let anyone else press the control button for you.
Benefits: you are usually the best judge of how much pain you have and how much pain relieving drug you require. PCA enables you to administer exactly the right amount of morphine for good pain relief with minimal side effects. The need for frequent injections is thus avoided.
Risks: Along with the side effects of morphine-like drugs already described, Patient Controlled Analgesia carries the risk of being a more complex technique with the potential for user error or pump malfunction. However, every effort is made to ensure that this does not occur. Our pumps are regularly checked and the nursing staff will continually monitor the effects of the medication on you. This has been shown to be at least as safe as morphine injections.
If you have any questions, please ask your doctor, nurse or a member of the Acute Pain Team.
