Pain relief after surgery

The type and amount of pain relief you will be offered will depend on the operation you are having and your pain levels after the operation. Some people need more pain relief than others. Generally, some degree of pain or discomfort can be expected during your recovery.

Good pain relief after your operation is important.

As well as making you comfortable, it allows you to get active more quickly and reduces complications. Good pain relief allows you to:

  • Breathe deeply and cough – reduces the risk of chest infections
  • Start eating and drinking – helps your recovery and your bowel function return to normal
  • Get out of bed and move around – Early movement helps prevent blood clots in your legs (DVTs) and helps you breathe deeply reducing chest infections. This also helps reduce muscle and energy loss.

Rating your pain

Your anaesthetist will discuss pain relief and the different options before your operation. You can decide your preferences and decide together the best plan for you.

Pain assessments are really important so that staff can understand if your pain is controlled well enough. You will be asked if you have pain on moving, deep breathing and coughing and is usually assessed on a scale of 1 – 10.

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It is important you are honest about your pain so you can be prescribed or given appropriate pain relief. You can ask for extra pain relief at any time during you stay in hospital.

It is easier to keep pain under control if treated early, so let your healthcare team know as soon as possible if your pain is getting worse. Occasionally pain is a warning sign of a problem or complication.

Types of pain relief

There are lots of way post operative pain can be managed. The boxes below will give more information:

  • Pills, Tablets or Liquid to swallow: These are used for all types of pain. They typically take about 30 minutes to work and are best taken regularly.
  • Injections into muscle: Typically, into your leg or buttock muscle and take about 20 minutes to work.
  • Intravenous pain relief: During your anaesthetic and in the recovery area your anaesthetist and nurses may give you drugs through your cannula. This means they work more quickly than if the same drugs are given as a tablet.

  • Paracetamol: Works well for post operative pain and works best if taken regularly every six hours. Can be safely taken alongside other forms of pain relief and can help improve their effectiveness.
  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): These include Ibuprofen, Naproxen and Diclofenac. They work by reducing inflammation and pain after surgery. They should be taken with food to reduce the risk of stomach complications. NSAIDs are not suitable for all people.
  • Opiates: These include Morphine, Codeine, Tramadol and Oxycodone. They are typically used after operations that cause considerable pain and can be given intravenously, as a tablet or liquid to swallow. Side effects are common with these drugs, such as nausea, itching, drowsiness and constipation.

  • Patient-Controlled Analgesia: This involves a machine with a button which, when pressed by you, delivers a small dose of strong opiate very frequently (usually every five minutes) directly into your cannula. It is programmed to ensure that you cannot give yourself an overdose. It is very safe, but as with all opiates can have side effects. A PCA puts you in direct control of your own pain relief.
  • Local Anaesthetic Catheters:  These are fine tubes placed just under the skin, by your anaesthetist or surgeon, near to your operation site. The tube is attached to a pump of local anaesthetic which blocks signals from nearby nerves giving pain relief. They can usually be kept running for several days.
  • Epidural Catheters: A fine tube in placed in your back using a needle. A pump runs local anaesthetic continuously and will make parts of your body numb depending on where the catheter is placed. The numbness will last as long as the catheter is in place and pump running. More information can be found on the RCoA leaflet on epidurals.

Alternatives in pain management

It is normal to feel some degree of discomfort or mild pain after surgery. The role of pain relief to so ensure you can breathe deeply, mobilise comfortably and if appropriate to start eating and drinking to give you the best recovery.

There are other things you can do to help with the recovery process to help manage any pain in addition to any medication you are prescribed.

This can include developing coping or relaxation strategies and positive thinking for any post operative pain or discomfort. Techniques such as mindfulness, visualisation, breathing exercises or even yoga can be really helpful in managing pain. These can help you restore a sense of control over your body and turn down the "fight or flight" response, which can worsen chronic muscle tension and pain.

Gentle exercise that doesn’t put too much strain on yourself can help your recovery. Lying in bed for long periods can make your pain last for longer and a lack of activity can stiffen your joints, sleep less well and lower your mood.

Cold or heat packs can be beneficial in relieving muscle and tissue pain. Over the counter packs can be effective and easy to use.

In some situations, a Transcutaneous Electrical Nerve Stimulation (T.E.N.S) machine can provide simple pain relief. This applies a safe and gentle electrical current across a small area and can help relieve pain and discomfort.

Going home

Depending on the type of operation you have had, you may be given a supply of painkillers to take home with you. These will be safe to take at home and should be enough to manage any pain or discomfort you have. However, it is sensible to buy some over the counter medication to have ready at home.

Regular use of these simple pain killers (such as Paracetamol and NSAIDs) significantly reduces the amount of strong painkiller you will need (such as morphine or codeine) and the side effects associated with stronger drugs. It is important that you reduce and then stop opioid-based pain killers as soon as possible because their continued use can cause you significant harm.

You will be advised before you go home how and when to reduce your pain killers after surgery and will depend on the type of surgery you have had and the length of time you have been in hospital.

If your pain increased as you reduce or stop your pain killers you should contact your GP or surgical team for further advice. It is also important to remember that mild post operative pain is normal and acceptable.