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Resources  |  Non-Opioid Pain Management

Managing Your Pain After Surgery Without Opioids (Adults)

Recent studies have shown that your surgical pain can be managed using non-opioid, over-the-counter pain medications (acetaminophen and ibuprofen).

How much pain will I have after surgery?
  • You can expect to have some pain after surgery.
    • This is normal and part of the healing process.
    • Your surgical pain is typically worse the day after surgery, and quickly begins to get better.
  • Everyone feels pain differently.
  • The goal is to manage your pain so you can do the things you need to care for yourself and heal:
    • Eat
    • Breathe deeply
    • Walk
    • Sleep

 

How will I manage my pain at home?

You will manage your pain after surgery by taking acetaminophen (Tylenol) and ibuprofen (Motrin or Advil) around the clock while you are awake. Alternating these medications allows you to get the best pain control.

How do I alternate my medications?
  • Take 650mg of Tylenol (2 pills of regular strength, 325mg Tylenol) every 6 hours while awake.
    • Do not take more than 3000mg of Tylenol in 24 hours.
  • Alternate with 600 mg of Motrin (3 pills of 200 mg) every 6 hours while awake.
    • Do not take more than 3200mg of Motrin in 24 hours.
  • Alternating these medications means you are taking a dose every 3 hours.
  • This is an example of how to alternate your medications, if you start at 12pm:

 

12:00 PM Tylenol 650 mg (2 pills of 325 mg)
3:00 PM Motrin 600 mg (3 pills of 200 mg)
6:00 PM Tylenol 650 mg (2 pills of 325 mg)
9:00 PM Motrin 600 mg (3 pills of 200 mg)
Continue alternating every 3 hours for 3 days, until no longer needed.  

 

What else can I do to help manage my pain?

Pain medications are only one part of your pain management plan. While taking your medications, you can also:

  • Use heating pads, or ice packs, as directed by your surgeon. Never put ice directly on your skin – use a towel to wrap the ice packs.
  • Try non-drug options such as relaxation, distraction (listening to music, reading, talking to others), mindful breathing, or daily reflections.

 

What if I still have pain?
  • You will receive a prescription for a small amount of an opioid pain medication (like Oxycodone or Tramadol).
  • You may use your opioid for severe pain in the first 24 hours after surgery.
    • Severe pain is pain that does not allow you to function (eat, breathe deeply, walk or sleep) and is not manageable using your scheduled Tylenol and Motrin.
  • Do not take more than 1 opioid pill every 4-6 hours, and only if needed for severe pain.
  • If you are having trouble managing your pain, call your surgeon or the number you were given at discharge.
    • Never take more opioid pills, more often, than prescribed.
    • Do not use your opioid pills for anything other than your severe surgical pain. For example, do not use your opioids to help you manage anxiety, to help you sleep or for other pain that is not from your surgery.
  • Stop taking the opioids as soon as possible.

 

What is an opioid?

Opioids are strong prescription pain medications with many possible side effects (e.g., dizziness, nausea, vomiting). Opioid use puts you at risk of dependence, addiction or overdose if taken accidentally, or for longer than a week.

 

How do I safely store my opioids?
  • Store your opioids in private, secure areas out of sight and reach of children, teen or pets. (like a locked drawer or cabinet).
  • Do not store your opioids in places, such as bathrooms, kitchens or purses, where others can easily find them.

 

Why should I dispose of my unused opioids?

72% of opioids prescribed to surgical patients go unused, creating an opportunity for misuse and diversion.1 Among those who misused prescription opioids, over 50% got them for free from a friend or relative.2 Diversion (sharing or selling) of opioids is a felony in Michigan.

 

How can I safely dispose my unused opioids?
  • Find a permanent medication drop box near you at: http://michigan-open.org/takebackmap/
  • Find a community Medication Take Back Event
  • As a last resort, use your household trash:
    • Place opioids into plastic bag, mix (do not crush) with used coffee grounds or kitty litter.
    • Throw into your trash.
    • Cross out any personal information on the pill bottle before recycling or throwing away.

References:
  1. Hill MV, McMahon ML, Stucke RS, Barth RJ, Jr. Wide Variation and Excessive Dosage of Opioid
    Prescriptions for Common General Surgical Procedures. Ann Surg. 2017;265(4):709-714.
  2. Jones CM, Paulozzi LJ, Mack KA. Sources of prescription opioid pain relievers by frequency of
    past-year nonmedical use in the United States, 2008-2011. JAMA Intern Med.
    2014;174(5):802-803.

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