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Acute Pain Management Guideline Panel. Pain Control After Surgery. A Patient's
Guide. AHCPR Pub. No. 92-0021. Rockville, MD: Agency for Health Care Policy
and Research, Public Health Service, U.S. Department of Health and Human Services.
Feb. 1992.
Pain Control Methods You May Be Using
To get the best results, work with your doctors and nurses to choose the
methods that will work best for you.
Your nurses and doctors want to make your surgery as pain free as they can.
But you are the key to getting the best pain relief because pain is personal.
The amount or type of pain you feel may not be the same as others feel--even
those who have had the same operation.
Before surgery
Drug treatment: Take pain medicine.
Non-drug treatment: Understand what operation the doctor is doing, why it is
being done, and how it will be done. Learn how to do deep breathing and relaxation
exercises.
During surgery
Drug treatment: Receive general anesthesia, spinal anesthesia, or nerve
blocks, or take a pain medicine through a small tube in your back (called an
epidural).

After surgery
Drug treatment: Take a pain medicine as a pill, shot, or suppository, or through
a tube in your vein or back.
Non-drug treatment: Use massage, hot or cold packs, relaxation, music or other
pastimes to distract you, positive thinking, or nerve stimulation (TENS).
What Can You Do to Help Keep Your Pain Under Control? These seven steps
can help you help yourself.
Before surgery
1. Ask the doctor or nurse what to expect.
- Will there be much pain after surgery?
- Where will it occur?
- How long is it likely to last?
Being prepared helps put you in control. You may want to write down your questions
before you meet with your doctor or nurse.
2. Discuss pain control options with your doctors and nurses.
Be sure to:
- Talk with your nurses and doctors about pain control methods that have worked
well or not so well for you before.
- Talk with your nurses and doctors about any concerns you may have about
pain medicine.
- Tell your doctors and nurses about any allergies to medicines you may have.
- Ask about side effects that may occur with treatment.
- Talk with your doctors and nurses about, the medicines you take for other
health problems.The doctors and nurses need to know, because mixing some drugs
with some pain medicines can cause problems.
3. Talk about the schedule for pain medicines in the hospital.
Some people get pain medicines in the hospital only when they call the nurse
to ask for them. Sometimes there are delays, and the pain gets worse while they
wait.
Today, two other ways to schedule pain medicines seem to give better results.
- Giving the pain pills or shots at set times. Instead of waiting until pain
breaks through, you receive medicine at set times during the day to keep the
pain under control.
- Patient controlled analgesia (PCA) may be available in your hospital. With
PCA, you control when you get pain medicine. When you begin to feel pain,
you press a button to inject the medicine through the intravenous (IV) tube
in your vein.
For both ways, your nurses and doctors will ask you how the pain medicine
is working and change the medicine, its dose, or its timing if you are still
having pain.
4. Work with your doctors and nurses to make a pain control plan.
You can use the form found to begin planning for pain control with your
nurses and doctors. They need your help to design the best plan for you. When
your pain control plan is complete, use the form to write down what will happen.
Refer to it after your operation. Then keep it as a record if you need surgery
in the future.
After surgery
5. Take (or ask for) pain relief drugs when pain first begins.
- Take action as soon as the pain starts.
- If you know your pain will worsen when you start walking or doing breathing
exercises, take pain medicine first. It's harder to ease pain once it has
taken hold. This is a key step in proper pain control.
6. Help the doctors and nurses "measure" your pain.
- They may ask you to rate your pain on a scale of 0 to 10. Or you may choose
a word from a list that best describes the pain.
- You may also set a pain control goal (such as having no pain that's worse
than 2 on the scale).
- Reporting your pain as a number helps the doctors and nurses know how well
your treatment is working and whether to make any changes.
- They may ask you to use a "pain scale" like the one shown.
7. Tell the doctor or nurse about any pain that won't go away.
- Don't worry about being a "bother."
- Pain can be a sign of problems with your operation.
- The nurses and doctors want and need to know about it.
Stick with your pain control plan if it's working. Your doctors and nurses
can change the plan if your pain is not under control. You need to tell the
nurses and doctors about your pain and how the pain control plan is working.
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