Pain Management After Surgery

This handout explains pain after surgery and what to expect. Pain is a normal part of healing. It is common after surgery. Most patients have less pain when they know their options. Less pain will help you heal faster. The goal is to get back to normal. It may not be possible to have no pain. We will work with you to manage your pain so that you can do everyday things like walk to the bathroom.

Some Things to Keep in Mind

• Both drug and non-drug treatments can help with pain. Many people use two or more methods for the best relief.

• Medicine options can include non-opioids and opioids.

• Each person is different. People respond differently to the same dose of medicine.

• We may not be able to get rid of all your pain.

• There are many pain control options to help you feel more comfortable.

• Sleeping is important and will help you heal.

Opioids

Opioid pain medicine may be needed if non-opioid pain relievers do not provide enough relief. Opioids will be stopped as soon as possible. Other medicines may be given at that time.

Side Effects

Opioids can cause side effects. Most side effects lessen over time. Some can be managed in other ways. You may have nausea and vomiting. If you can eat, take your pain medicine with food to help with this. Constipation is another common side effect. Call your doctor if you have not had a bowel movement in 2-3 days. Some things that may help include:

• Eating foods high in fiber.

• Drinking fluids.

• Taking a stool softener or laxative, if advised.

One of the more serious side effects is slower breathing. The risk is higher if you have sleep apnea or if you take other medicines that make you feel sleepy. Slower breathing can lead to more severe breathing problems and even death.

Another side effect is dizziness. Change positions slowly. For example, sit, then stand up slowly after lying down. You should also avoid alcohol.

Opioid Use Before Surgery

If you usually take opioid medicine, you may need higher doses after surgery. Pain control after surgery may be harder. We will watch closely to make sure you do not get too much medicine. Our goal is to get your pain back to the level you had before surgery.

Non-Opioids

Tylenol (acetaminophen) works well and has few side effects. This can be a good addition to your pain plan. At home, check your medicine labels for Tylenol. Look for anything with “APAP” or “acetaminophen” on the label. Do not take more than 4,000 mg daily. Too much Tylenol can damage your liver. Patients with liver disease must speak with their doctor before taking Tylenol.

Other Ways to Reduce Pain

• Relaxed, deep breathing

• Imagery (imagine a peaceful place)

• Massage

• Music

• Movies, videos, or TV

• Talking with others

• Games/puzzles

• Walking

• Quiet time

• Keeping parts of your body elevated to help reduce swelling

• Heat or cold packs (ask your nurse which is right for you)

• TENS unit (transcutaneous electrical nerve stimulation)

• MyChart Bedside iPads

Things to Discuss Before Surgery

• Ask, “Where will my pain be?” and, “What can I expect?”

• Share what things worked well in the past to help with pain. This could include medicine or other strategies. Talk about what did not help.

• Provide a list of over-the-counter medicines or herbal supplements you take.

• Discuss side effects you may have had in the past like upset stomach, constipation, or dizziness.

Rating Your Pain

The scale below helps your healthcare team understand your pain and ability to function. You can also use the words mild, moderate, or severe. Ask for medicine when you first feel pain. Do not wait until it gets severe.

When to Call

While in the hospital, let the nurse know if you have pain that is not controlled or if you are having any side effects. After you go home, call the clinic where your surgeon works to report pain that isn’t going away or side effects.