Post Op Pain Management or Post Surgical Pain Management
Is Post Op Pain or Post Surgical Pain Intolerable?
Not really, post op pain or post surgical pain is severe and intolerable if not treated appropriately. Post op pain management or post surgical pain management is much advanced today than few years ago. Post op pain or post surgical pain has two phases, immediate and delayed phase. Pain is treated differently in each phase.
What is Immediate Post Op Phase or Post Surgical Phase?
Immediate post op phase or immediate post surgical phase is the recovery phase after surgery and it may last for the period of 30 minutes to 6 hours after surgery. During this phase patient is often drowsy and sleepy. Patient is closely monitored for pain after surgery. Post op pain or post surgical pain is considered as one of the vital sign just like heart rate, body temperature, respiration and blood pressure. Immediate postoperative phase lasts until patient is discharged home from recovery room or discharged to inpatient hospital floor. Postoperative, patient will be discharged home from recovery room when patient is well oriented and able to take care of his daily activities.
How is Pain Treated During the Immediate Post Op Phase or Post Surgical Phase?
Patient is brought to the recovery room after surgery. Recovery nurse closely monitors patient. Patient is often drowsy, awake and alert at the arrival in recovery room following surgery. Patient may not complain of post op pain or post surgical pain during first few minutes or hours until all anesthesia effects are worn out. Patient is frequently asked regarding pain. During immediate post op phase or post surgical phase, the pain is treated with intravenous or intramuscular pain medications. Pain relief is immediate and recovery nurse closely observes for side effects if any.
Patient will be admitted in the hospital for 23 hours. Patient will be re-evaluated after 23 hours to be discharged home.
What Happens if Patient is Unable to go Home After 23 Hours Following Surgery?
Patient may be unable to go home post op or following surgery either because of severe pain not responding to oral pain medication or need for urgent treatment for complications arising after surgery. Severe post op pain or post surgical pain may need to be treated with intravenous opioids. Intravenous opioids cannot be given at home and needs close supervision. Similarly, after the surgery if patient is suffering with complication, which needs further treatment, then patient cannot be discharged until complication is resolved. Patient is admitted as inpatient after 23 hours if necessary.
Does the Post Op Patient Have to Pay for Inpatient Admission Since He/She Had Same Day Surgery?
No, there are established criteria for same day 23 hours admission and inpatient admission following surgery. You will be admitted only after clinical examination and discussion with insurance provider fulfills the criteria for admission following surgery. Insurance provider is responsible for all treatment and cost of treatment post op.
What are the Side Effects of Pain Medications for Post Op Pain or Post Surgical Pain?
Mild to moderate post op pain or post surgical pain responds to anti-inflammatory pain medications. Anti-inflammatory pain medications are safe if used for short period of time. Severe post op pain or post surgical pain is treated with opioids. Most common opioid side effects are nausea, vomiting and itching. Vomiting may need 23-hour admission or inpatient admission.
What is Delayed Post Op Phase or Post Surgical Phase?
Delayed post op phase or delayed post surgical phase is more or less after 24 to 48 hours. During this phase, the post op patient is either admitted in hospital or discharged home.
How is Pain Treated During the Delayed Post Op Phase or Post Surgical Phase?
Mild to moderate post op pain or post surgical pain is treated with anti-inflammatory medications. Severe post op pain or severe post surgical pain is treated differently if patient is admitted in the hospital or discharged home. Patients admitted in the hospital following surgery are mostly treated with intravenous opioids and the patients who are discharged home after surgery are treated with oral opioids.
Do Patients Need Heavy Dosage of Opioids if They Have Low Tolerance for Pain and High Resistance to Opioids?
Patient may have low tolerance to pain and opioid may not give them a satisfactory pain relief. Post op patients may have to take anti-inflammatory pain medication or adjuvant pain medication with opioids. One has to be careful to avoid drowsiness and sleepiness by over medicating themselves at home or demanding too much opioid during hospital admission.
Why Should the Patient Be Careful to Demand More Opioids for Uncontrolled Post Op Pain or Uncontrolled Post Surgical Pain?
If the post op pain or post surgical pain is not responding to opioid dosage as prescribed by your physician, then you should contact your physician as soon as possible. Cause of post op pain or post surgical pain must be established by urgent examination and investigation. If all tests are negative you may need hospital admission and intravenous pain medication for short period of time. Opioids can cause respiratory depression if given in larger dosage or continuously supplied to a patient who is drowsy and sleepy. If you are at home and feeling drowsy or sleepy you should avoid taking opioid until you feel wide alert and in severe pain. Toxic dosage of opioid suppresses brain and result in slow and shallow breathing. Slow, shallow breathing will cause increase carbon dioxide in blood and less oxygen. Patient may end up unconscious and hypoxic (severely deprived of oxygen). Such conditions are life threatening.
How Long Can Post Op Pain or Post Surgical Pain Last?
Post op pain or post surgical pain may last for 5 to 15 days. Pain is severe in the beginning and intensity decreases with time. Most of the post op pain or post surgical pain, after 2 to 3 days, is tolerable and responds to anti-inflammatory pain medications such as Tylenol, Motrin, and Naproxen.
For How Many Days Will The Patient Have to Take Opioids Following Surgery & Discharge?
Acute post op pain or post surgical pain is intense for 48 to 72 hours. Pain intensity reduces with time. You may have to take opioids for 2 to 5 days if you had surgery involving skin, muscles, abdomen or brain. You may need opioid longer than one week, up to 4 week if you had thoracic and orthopedic surgery. Acute post op pain or post surgical pain following orthopedic surgery such as repair of fracture, joint dislocation and joint replacement lasts longer than 3 to 4 weeks.
How Does the Post Op Pain or Post Surgical Pain Decrease in Intensity in First Few Weeks?
Incision and wound start healing immediately after surgery. Nerves and nerve receptors are less irritated after 48 hours resulting in less pain. Scientific research also suggests that 48 hours after surgery body start producing endorphin. Endorphins are protein molecules, which functions as analgesics and relieves pain.
Do the Patients Get Addicted to Opioids Following Surgery?
No, you will not be addicted to opioids unless you were taking opioids prior to surgery or you were dependent or addicted to opioids before surgery. Opioids are safe when prescribed for acute pain following surgery and continued for 2 to 3 months if necessary. In majority of cases you may not need opioids for more than 2 to 3 weeks after surgery.