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Managing Your Pain After Surgery (Adults)

Understanding Surgical Pain

  • The GOAL OF PAIN MANAGEMENT is for you can do the things you need to care for yourself and heal like:
    • Eat
    • Breathe deeply
    • Walk
    • Sleep
  • 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) mediations like acetaminophen (Tylenol) and ibuprofen (Motrin)
  • Adding non-medication options to your pain management plan can help to successfully treat pain

BEFORE SURGERY, DICUSS WITH YOUR SURGEON:

Substances and Medications You Use

  • All substances you are taking, 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

  • How long should you expect to have pain
  • What do patients having the same surgery as you typically find successful to manage 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 in 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

  • What OTC medications are you able to take
  • What is the proper dose for you 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 strong pain medication that may be prescribed by your surgeon to use after surgery as one way to manage pain.

Opioid Use

  • Use opioids ONLY for severe breakthrough pain that is not controlled with OTC medications
  • As pain gets better, stop using or use fewer opioids
  • Do not use opioids at the same time as alcohol,  muscle relaxers, or other medications that can cause sleepiness
  • If you are pregnant or planning to become pregnant, using opioids 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 a 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 prescribed

Overdose and Death

Opioids can cause slowed breathing and lead to overdose and death. Discuss the following signs and symptoms 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:

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

How to Store and Dispose of Medications including Opioids

It is YOUR responsibility to safely store ALL medications and dispose of opioids when finished.

Why?

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.

Medication 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 drobox often located at pharmacies, police stations, or other community areas
  • Drop off opioids 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

 


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.