On admission, you will be prescribed anti sickness medications and painkillers. These medications may not be prescribed as regular medications, but as PRN medications meaning you will not routinely be asked if you would like them during medication rounds, but can request them as you require them. It is important that you let your nurse know if you are experiencing pain, nausea or vomiting as this may prevent you from meeting the requirements of the Enhanced Recovery Programme and hinder your recovery.
Pain relief following surgery
- Pain after surgery is one of the main worries or concerns that patients have when coming in to have an operation. Being in some pain after surgery is normal and the goal is to minimise and control the amount of pain you will experience rather than eliminate it all together.
- It is extremely important that if you suffer from a persistent pain condition that you inform the anaesthetist, surgeon or ward doctors of any medication you take for this. These may include medications prescribed by your doctor, over the counter medications or illicit substances. This will help us to better understand and manage your pain.
- Whilst in hospital you will be regularly asked to rate your pain. It is important that you consider your pain levels on moving and not just when you are sat or laid still. Your pain levels should not inhibit your ability to deep breathe, cough or mobilise.
- If you are able to eat and drink after surgery, you may be given oral tablets or liquid to help manage your pain.
- For certain surgeries, there are other pain relieving techniques that may be used if your anaesthetist or surgeon feels they will be more appropriate.
- It is likely you will receive a spinal injection either before or during your operation.
- This is given to relieve pain immediately after surgery and give time for other methods of pain relief to take effect.
- When you wake up after surgery, you may find that your legs are very heavy or completely numb.
- This is normal after a spinal injection. You should fully regain feeling and movement in your legs after six hours from returning to the ward.
- When the spinal anaesthetic wears off, you may start feeling pain build up. There are different ways that we can help manage pain after surgery.
- If you are able to eat and drink after surgery, you will be prescribed painkillers which are taken orally.
- These can come in different preparations including long acting tablets (continuous release) and short acting tablets or liquids (immediate release).
- The long acting tablets are given at regular intervals throughout the day. The aim is to help to reduce your pain to a manageable level. However it is highly unlikely to completely eliminate your pain.
- Short acting tablets can be given regularly to help keep pain at a manageable level. The immediate release painkillers are given if the pain increases. This is called breakthrough pain.
- Combining both long acting and short acting painkillers should help control the pain enough for you to be able to deep breath, cough and mobilise.
- If you are not able to eat and drink, there are other options available to manage pain.
- A PCA machine gives control of managing your pain directly to you.
- A PCA consists of a locked machine containing a syringe of a strong painkiller, and a button that is given to you.
- Pressing the button gives a small dose of a strong painkiller directly into your vein, so it works quickly.
- After you press the button, it will lock out for 5 minutes for safety to stop you having too much.
- Once you are able to eat and drink, we will look into swapping the PCA for tablets and liquid painkillers.
- You can press your button to give yourself a dose of painkiller before coughing, or having physiotherapy to help with pain.
local anaesthetic
- A wound infusion gives a constant flow of local anaesthetic to where you have had your surgery.
- One or two very thin tubes are inserted during your surgery and attached to a locked machine.
- The local anaesthetic soaks into the area around where you have had your surgery, and helps to keep the area a bit more numb that it would be without it.
- The rate of the infusion can be increased or decreased depending on how well it is working.
an epidural
- An epidural infusion is designed to keep a certain area of your body numb.
- A thin tube is inserted into your back before or during the operation.
- The aim is to keep a certain area of your body pain free.
- Staff will frequently check the strength in your legs and arms whilst the epidural is running.
- The effectiveness of an epidural is checked by spraying you with a cold liquid in certain areas of your body. You may feel a reduced sensation to temperature in the affected areas, or no sensation at all.
- The Acute pain team consists of an anaesthetist and a team of specialist nurses in the hospital that focus on pain after surgery.
- If you have a PCA, Wound Infusion or Epidural, one of the pain nurses will see you the next working day after your operation to check how you are doing.
- We aim to see you every weekday that one of the techniques are in use.
- We will also come to see you if you are in more pain than expected or your painkillers are not working.