How to prepare for postoperative pain before your surgery

An aspect of surgery that patients can feel the most anxious about is not the procedure itself but what comes after. A surgery may only take three hours but require three months to recover from, and in that time, the patient must likely deal with some postoperative pain. Of course, to be expected when the body has been cut open and put back together again, even by the most skilled hands. In this guide, Dr Nofil Mulla, a consultant pain physician and intervention specialist, shares tips and advice for preparing and managing postoperative pain, before the surgery.

What are the effects of postoperative pain?

Managing pain after surgery is not only about physical comfort, but can also facilitate the healing process and prevent complications. Severe pain after surgery can:

• Slow down wound healing
• Prevent sleep
• Restrict deep breathing, which reduces oxygen in the blood and also heightens the risk of upper respiratory tract infections
• Cause heart palpitations
• Raise blood pressure
• Cause a deterioration of the mental state such as depression and anxiety

This goes to show that postoperative pain management is very much an actual clinical concern.

What are the options for postoperative pain management?

There are many methods and forms of postoperative pain management, and the one that best suits you will depend on the kind of surgery you had, where the pain is being felt, as well as your projected recovery process. You may be recommended multiple kinds of pain relief to be used simultaneously. Some pain management techniques are strictly available on whilst staying in the hospital, whereas some are prescribed to be taken at home, and some can be purchased over the counter and do not need a prescription.

Some of the many types of pain management are:

• Opioids, at home and at the hospital, are best for severe pain but there is a risk of abuse
• Nerve blocks and local anaesthetics
• Epidural, which is administered through a catheter near the spinal cord
• Intravenous pain medicine
• Patient-controlled analgesia (PCA), in which pain medicine is administered at the patient’s inclination via an intravenous line during the hospital stay
• Topical analgesics, such as creams, patches, and gels
• Steroids, to treat swelling
• Physical therapy and massages, to stimulate muscles, and improve strength, flexibility and function.
• Transcutaneous electrical nerve stimulation (TENS), which uses electrical signals to interrupt pain receptors
• Cognitive behavioural therapy, to learn coping skills on how to deal with pain
• Anti-inflammatories like ibuprofen and naproxen

What do to before the surgery:

To prepare for pain after the surgery, there is some homework that you’ll need to do before. You should discuss with your surgeon or care team about expectations, recovery time, and your previous personal experience with pain.

You should give your team a list of all your current medications, prescriptive or not, including supplements and herbal remedies as they can affect or even counteract pain management methods. Inform them of your alcohol and drug use, if ever, so they have a full idea of how different substances will interact in your body.

If you have any concerns or questions, it’ll be the best opportunity to ask about them, so that you do not worry about them after your surgery, and you can go into the operation theatre feeling assured.

If there’s any specific medication or method for managing pain that you want to avoid or are worried about the side effects, express this to the team so they can assuage your fears or offer alternatives. You may be considering forgoing pain medication entirely, or want to know if there are counselling, behavioural, or physical treatments that can assist with pain management, so it is also a good idea to ask them for suggestions about this. Well before the surgery, be sure to understand what physical rehabilitation you may have to undergo, or how you may be physically impaired while recovering so that you can arrange your living spaces to accommodate your mobility and reduce discomfort or possible injuries upon going home.  

If you have concerns regarding postoperative pain management, consult with Dr Mulla via his Top Doctors profle.