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Managing Pain After Surgery (Adults)

Understanding Surgical Pain

  • The GOAL OF PAIN MANAGEMENT is for you to do activities of daily living like:
    • Eat
    • Sleep
    • Breathe deeply
    • Walk
  • Pain after surgery is normal
    • While everyone feels pain differently, typically surgery pain is the worst during the first 2-3 days after and then begins to get better
  • Pain may be well-controlled with a schedule of over the counter (OTC) medications like acetaminophen (Tylenol®) and ibuprofen (Motrin®, Advil®)
  • Adding non-medication options to your pain management plan can help to successfully treat pain

BEFORE SURGERY, DISCUSS WITH YOUR SURGEON:

Medications and Substances

  • Review with your surgeon and ask for recommendations for how to take your medications prior to surgery including:
    • Alcohol
    • Tobacco
    • Antidepressants (like Prozac® or Celexa®)
    • Sedatives (like Ambien® or Seroquel®)
    • Benzodiazepines (like Valium®, Xanax®, or Klonopin®)
    • Stimulants (like Adderall®, Ritalin®, or Vyvanse®)
    • Opioids (like Oxycodone®, Vicodin®, or Norco®)
    • Any other substances (like Marijuana, Crack/Cocaine, Methamphetamine)

Pain Expectations

  • What type of pain you will have
  • How long you should expect to have pain
  • What you should do if your pain is not controlled

Non-Medication Options

  • Many techniques exist to successfully treat pain and can be used alone or in conjunction with medication. Here are a few examples:
    • Meditation
    • Music
    • Reading
    • Relaxation
    • Mindful breathing
    • Short walks
    • Ice
    • Compression (with surgeon approval)

Using OTC Medication

  • If you can use OTC medications after surgery
  • Appropriate dose and how often to take
    • Example: For the first 3 days after surgery take OTC medications at regularly, scheduled times

 

TimeMedication (Dose)
9 AMTYLENOL (1000mg)
MOTRIN (600mg)
3 PMTYLENOL (1000mg)
MOTRIN (600mg)
9 PMTYLENOL (1000mg)
MOTRIN (600mg)

 

OPIOID USE FOR SURGICAL PAIN

What is an Opioid?

An opioid is a prescription pain medication that may be prescribed by your surgeon to use after surgery.

Most Common Opioids

Generic NameBrand Name
CodeineTylenol® #3* or #4*
FentanylDuragesic®
HydrocodoneVicodin®*, Norco®*
HydromorphoneDilaudid®
MethadoneMethadose®
MorphineMS Contin®, Kadian
OxycodonePercocet®*, OxyContin®
OxymorphoneOpana®
TramadolUltram®, Ultracet®*

*Contains acetaminophen (Tylenol®). Use caution if you’re taking acetaminophen

Opioid Use

  • Use opioids ONLY for severe breakthrough pain that is not controlled with OTC and as pain gets better, stop using or use fewer opioids
  • Do not use opioids at the same time as alcohol, benzodiazepines, muscle relaxers, sleep aides, or other medications that can cause sleepiness
  • If you are pregnant or planning to become pregnant, using opioid medications can cause harm to a fetus, including neonatal abstinence syndrome
  • Talk to your Surgeon about a prescription for Naloxone which is a medication that temporarily reverses the dangerous effects of an opioid overdose

Know the Risks

Anyone who uses an opioid, even for just a short time, is at risk for dependence, tolerance, misuse, addiction, and overdose. This risk may be higher in individuals with a history of:

  • Substance use disorder
  • Tobacco use disorder
  • Mental illness
  • Long-term (chronic) pain
  • Sleep apnea or breathing problems
  • Taking opioids for longer than a few days or more often than prescribed

Overdose and Death

Opioids can cause slowed breathing and lead to overdose and death. Discuss the following signs and symptoms of an overdose with your family and friends:

  • Cannot be awakened or are unable to speak
  • Vomiting or making gurgling noises
  • Limp body that may seem lifeless
  • Fingernails or lips turned blue/purple
  • Extremely pale or feels clammy to the touch

Other Side Effects from Opioids

Contact your surgeon if you notice any of the following:

  • Constipation
  • Itching
  • Sleepiness
  • Nausea or vomiting
  • Impaired motor skills, thinking, or judgment

 

Opioid Storage

  • Lock up medication if possible
    • Try a medication lock box, safe, or drawer with a lock
  • Store medications in private areas, do not store in common rooms like the bathroom or kitchen
    • Do not store in a purse
  • Keep count of how much medication is left
  • Talk about the risks of opioids with family and friends

Opioid Disposal

  • Use home disposal options such as deactivation bag or medication mail-back envelope
  • Use a permanent medication dropbox often located at pharmacies, police stations, or other community areas
  • Drop off opioids and medications at a community Take Back Event
  •  Use your household trash as a last resort:
    • Mix opioids (do not crush) with used coffee grounds or kitty litter in a bag and throw away
    • Take personal information off of the prescription label before disposal
  • Click here to find a disposal location near you

 


Cite this work:
OPEN: Opioid Prescribing Engagement Network (2022). Managing Pain After Surgery [English]. Retrieved from https://doi.org/10.56137/OPEN.000027