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Postoperative Pain Management

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What is Postoperative Pain Management?

Postoperative pain management refers to the techniques and interventions employed in the management of pain after surgery.

Pain is an unpleasant feeling or discomfort caused by an injury, illness, or emotional disorder. Pain can be differentiated into two basic types: acute pain and chronic pain. Acute pain is pain that usually lasts 3 to 6 months. It typically comes on suddenly and is sharp in nature, such as after a trauma or surgery. Chronic pain is pain lasting longer than 6 months and is secondary to a condition affecting a specific body part or the whole body.

Postoperative pain is experienced by almost all individuals who undergo operative procedures. Management of postoperative pain plays a key role in facilitating an individual’s recovery to normal function and decreases the rate of adverse psychological and physiological effects related to acute, uncontrolled pain. The objective of postoperative pain management is to minimise patient discomfort, facilitate early mobilisation and functional recovery, and prevent acute pain from developing into chronic pain.

Postoperative pain can be treated in a variety of ways and depends on the type of pain being experienced by the patient. Some of the common treatment modalities used for postoperative pain management include:

  • Intravenous Patient-Controlled Analgesia (PCA): Patient-controlled analgesia involves a computerised pump that safely allows you to click a button and deliver a small quantity of pain medicine into your intravenous (IV) line, typically in your arm. PCA offers stable pain relief in most conditions. Many patients enjoy the feeling of being in control of their pain management. The PCA pump is programmed to provide a certain quantity of medication when the button is pressed. It will only enable you to have a specific amount of medication, no matter how often you click the button, so there is little worry that you will administer yourself too much medicine.
  • Patient-Controlled Epidural Analgesia: Epidural analgesia is normally more successful in decreasing pain than IV medication. Patient-controlled epidural analgesia utilises a PCA pump to supply pain-control medicine into an epidural catheter (a thin plastic tube) that is placed into your back. Placing the epidural catheter (to which the PCA pump is connected) typically causes no more discomfort than having an IV started. The skin of your back is sterilised with an antiseptic solution and numbed with a local anaesthetic. Next, a thin needle is carefully inserted into an area in the spine called the epidural space. A thin catheter is then placed through this needle into the epidural space, and the needle is then withdrawn. During and after surgery, pain medications can be infused through this epidural catheter with the objective of offering you exceptional pain control at the touch of a button.
  • Nerve Blocks: Unlike an epidural, which manages pain over a broad section of your body, a nerve block controls pain confined to a smaller section of the body, such as a leg or arm. In some cases, a catheter similar to an epidural catheter is inserted for prolonged pain control. One advantage of a nerve block is that it may enable the quantity of narcotic (opioid) medication to be greatly reduced. This may lead to fewer side effects, such as drowsiness, nausea, and vomiting. Sometimes, a nerve block is used as the main anaesthetic for your operation. In such cases, you will be provided medications at the time of your operation to keep you sleepy, relaxed, and comfortable. This type of anaesthesia offers the added advantage of pain relief both during and after your operation, along with the reduced risk of nausea and vomiting afterwards.
  • Oral Pain Medications: Postoperative pain can also be managed by over-the-counter medications taken by mouth, such as the prescription pain medications aspirin (Bayer), acetaminophen (Tylenol), and ibuprofen (Motrin). Medications such as ibuprofen also assist in reducing swelling and inflammation. Non-medication alternatives, such as relaxation techniques, heating pads, or ice packs that assist with pain or swelling relief, can be utilised instead of, or along with, medications.
  • The Society of British Neurological Surgeons
  • British Orthopaedic Association
  • British Association of Spine Surgeons
  • North American Spine Society