Summary

Pain after an operation is a common problem but there is no need for you to be in a lot of pain. Pain relief after surgery is usually safe and effective.

What are the benefits of pain relief?

Operations cause pain. If you have good pain control after your operation, you are less likely to have a heart attack, a chest infection or blood clots. You should also get up and about more quickly and may go home sooner.

1 Simple Painkillers

You can use these on their own or combined with other painkillers. After your operation take simple painkillers such as paracetamol, anti-inflammatory painkillers such as ibuprofen, and codeine or similar painkillers like tramadol. Although these painkillers may not completely treat your pain, if you take them regularly they reduce the amount of other painkillers you might need.

What complications can happen?

The risks with simple painkillers are small.
  • Paracetamol is exceptionally safe in normal doses.
  • Anti-inflammatory painkillers can sometimes cause stomach irritation and can make asthma worse.
  • Codeine or similar painkillers can make you feel sick or light-headed.  They can make you itch and almost always cause some degree of constipation.

2 Morphine and Similar Painkillers

For more severe pain you may be given morphine or similar painkillers, such as pethidine, fentanyl or oxycodone.

Intravenous delivery (using a drip)

The most common intravenous delivery is a technique known as patient-controlled analgesia or PCA. This involves connecting a pump, containing the painkillers, to a drip in a vein. When you press a button on the pump a small dose of painkillers will be given.

Other ways of giving morphine and similar painkillers

The painkillers can be given by mouth once you are eating and drinking normally. The painkillers can be given by injection either under your skin or into the muscle.

What complications can happen?

  • Itching
  • Constipation
  • Feeling or being sick
  • Respiratory depression
  • Confusion

3 Epidural Anaesthetic

An epidural involves inserting a fine catheter into the epidural space near your spinal cord. Most of your nerves pass through this space. Local anaesthetics and other painkillers are injected down the catheter into the epidural space to numb your nerves. Sometimes the anaesthetic is injected continuously (infusion). The dose can be varied by the healthcare team. As well as continuous infusion you can sometimes have a button that allows you to ‘top up’ the epidural by giving a small, safe dose when you need it.

What complications can happen?

  • Low blood pressure
  • Headache
  • Respiratory depression
  • Seizures
  • Unexpected high block
  • Infection around your spine
  • Cardiovascular collapse
  • Nerve damage
  • Blood clot around your spine
  • Damage to nerves
  • Paralysis or death

4 Peripheral Nerve Blocks

You may be offered a peripheral nerve block to give pain relief after an operation on your arm or leg. A nerve block works by temporarily numbing your nerves to give pain relief. This involves injecting anaesthetic and other painkillers near the major nerves to your arm or leg.

What complications can happen?

  • Failure of the nerve block
  • Allergic reaction
  • Bleeding
  • Nerve damage
  • Local anaesthetic toxicity

Acknowledgements

Author: Dr Iain Moppett DM MRCP FRCA and Dr Rakesh Kapila MBChB FRCA

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Last updated: July 2017

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