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Frequently Asked Questions (FAQs)

Preparing  For Your Operation

Managing Pain After Your Operation

Preparing  For Your Operation

How much pain should I expect?

In hospital, the doctors and nurses will try to keep you as comfortable as possible, but it is not realistic to expect no pain after an operation. We expect that most patients will have pain that is mild at rest and on movement, but this will depend upon the exact operation that you have had. The day of your operation and perhaps the day after, we would expect that you may have some pain that is moderate, especially when you are moving. You may feel some muscle aches after lying on the operating table for some time. You may also feel that you have a sore or irritated throat from the tube that helps you breathe during the operation. This pain will get better quite quickly. We would hope that your pain is not severe. If it is, you must tell your doctor or nurse and they can help you. They may use non-drug ways of doing this, such as making you more comfortable in bed, or they may choose to give you another pain medicine. Pain after an operation normally gets better every day, but you should expect that your pain may increase a little on the first day that you start to move a little bit more. You can ask your nurse or doctor for more pain medicines if you feel you need them.

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Which pain medicines will I be given? Do they have side effects?

The doctors looking after you will choose the pain medicines that they think will work best for you. They will also choose the pain medicines that they think will be the safest for you. Most medicines (not just pain medicines) have some side effects but most of these are things that, after a day or so, your body will become used to and you will no longer feel these side effects. If these side effects are very bad, your doctor may choose a different pain medicine for you. Below are links to information about the pain medicines we use at St George’s hospital and helpful ways of avoiding side effects:

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I don’t like to take too many medicines. Why should I take pain medicines?

Doctors and nurses understand that most patients do not like taking lots of different medicines. It is very important to all of the staff in the hospital that patients do not take medicines that they do not need. Doctors now understand that having lots of pain after surgery is not very good for you. It is normal for pain to be moderate in severity the day after surgery, but after this, we would hope that your pain would be mild when you are not moving and moderate at worst when you are moving. If you are in constant severe pain after an operation, your body may find it difficult to heal wounds and recover. If you are not able to cough properly, breathe deeply or move properly after an operation, it is possible that you will get a chest infection or experience other problems such as blood clots in your legs.

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I’ve heard of ‘Patient Controlled Analgesia ‘ (PCA), ‘ epidural analgesia’ and ‘spinal analgesia’. What do they mean?

Depending on the operation that you are having and any previous operations or illnesses that you have had, your anaesthetic doctor will decide how your pain will be managed. They will be happy to involve you in this decision if you would like. Anaesthetic doctors are very experienced in pain relief following surgery and they will want to prescribe the safest and most appropriate medicine to manage your pain.

The links below will give you more information on different ways of controlling pain after your operation:

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I already take strong pain medicine. Should I take them when I am in hospital?

If your operation is elective (planned) then you will be seen at a pre-assessment clinic. If you take regular pain medicines at home, you should tell the nurses in the pre-assessment clinic this. They will tell the doctors about the pain medicines you take and they will decide if you should continue taking them when you are in hospital. If your operation is an emergency, then you must tell the doctors looking after you about the pain medicines that you normally take. If you have ever been seen by a chronic pain doctor, you should also tell them about this. It is very important that you do not take any medicine in hospital unless the doctors and nurses looking after you know that you are taking it.

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What happens if my pain is poorly controlled?

If you are in pain, you should let the nurses and doctors looking after you know this.  After some operations, physiotherapists and occupational therapists may want to help you get out of bed and sometimes they will help you to do exercises. It is important to let them know that you are in pain too. Taking regular pain medicines is very important in managing your pain after an operation. It is very important that you take pain medicine before the pain becomes severe, because the more severe the pain, the harder it is to relieve.

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Will I get addicted to pain medicines?

It is common for patients to worry about becoming addicted to opioid pain medicines (opioids are medicines that are similar to, and include, morphine) but this is something that happens very rarely. It is usually only when pain medicine is taken in very high doses that a feeling of euphoria (intense happiness) happens. It is this feeling of euphoria that causes people to develop an addiction.  Doctors and nurses will prescribe your pain medicine in doses that will be very unlikely to cause an addiction.

If you take opioid pain medicines for a long time, your body begins to develop a dependence. This is not addiction. Dependence means that if you stop taking the opioid medicine suddenly you may experience ‘withdrawal’. ‘Withdrawal’ symptoms may  include diarrhoea, cramps, aching muscles, goosebumps and anxiety/agitation. Your doctors and nurses will reduce your pain medicine slowly so that you are very unlikely to experience this.

Sometimes, patients’ relatives can also worry about addiction and your relatives might tell you not to take your pain medicine. If this happens, it is important that you ask your relative to speak to your doctor or nurse, so that they can speak things through with them.

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Pain medicines make me constipated. How can I avoid this?

Constipation is a very common side effect of many of the opioid pain medicines. Luckily, it can easily be avoided by following some simple advice:

http://www.patient.co.uk/health/constipation-in-adults-leaflet

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Some pain medicines make me feel sick.  Are there others I can take?

Nausea  (feeling like you might be sick) can be common in hospital, for many different reasons.  While it might not be the pain medicines you are taking that are making you feel like this, this can sometimes be a side effect of any drug. It is important to tell the doctor or nurse looking after you that you are having this problem.

Some common medicines used to help with sickness in hospital:

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Managing Pain After Your Operation

Why have I been prescribed paracetamol when I am in lots of pain?

Pain experts have discovered that ‘multi-modal’ ways of managing pain are likely to give you the best relief from your pain. This means using a few different pain medicines at the same time that work in different ways. Paracetamol is a pain medicine that is thought to be the basic building block on which the other pain medicines can work. When taken at the correct dose and the correct time, it is one of the safest pain medicines and has the fewest side effects. Your doctor may choose to give you pain medicine to take alongside paracetamol. It is important that you keep taking the paracetamol because it usually makes the other pain medicines work better. The other pain medicines tend to have more side effects. If you take paracetamol, it is likely that you will need less of these other medicines and because of this, you are less likely to have unwanted side effects. If you do have side effects, they are likely to be less severe.

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Are there ways I can help my pain without medicine?

There are a number of ways that you can help to relieve your pain without taking medicine. These methods can also be useful alongside pain medicines. Doctors and nurses will never force you to take medicine that you do not want to take, but it is normal to need quite strong pain medicine for at least a few days following an operation. Doctors and nurses can advise you, but they also know that you are the best person to decide how much, or how little, pain you are in.

Please note, it is not advisable to use heat or cold therapy for at least a week after an operation. It is best to leave heat or cold therapy until you are at home. If you really feel that this type of therapy would help you, make sure you ask your doctor or nurse if it is a good idea first.

The links below provide some useful ways of managing your pain either without, or in addition to pain medicine:

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Why do I need to take pain medicines if I have no pain if I don’t move?

It is very important that you are able to cough, deep breathe and move in the days and week following surgery. These three activities are very important in avoiding complications after your operation ( see question 3. ). Pain medicine will not usually take your pain away completely, but it will make it easier for you to do cough, deep breathe and mobilise and in this way, it will help you to recover more quickly.

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My doctor or nurse has told me I have ‘neuropathic’ or ‘nerve’ pain. What does this mean?

During surgery, or at the time of an injury, nerves in your body can become injured. This can happen quite often and is usually not anything to worry about. With time and sometimes with the help of different medicines, this pain usually gets better.  Click on the link below to find out more about neuropathic pain and how it is different from other pain you might have:

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Why have I been prescribed anti-depressants for pain relief?

Most of the medicines used to treat neuropathic (nerve pain) are also used to treat other conditions. It is important that you know why these medicines are being given to you. Anti-depressants are often used in nerve pain, but it does not mean that your doctors or nurses think you are depressed. If you do not know why these medicines have been given to you, your doctor or nurse will be able to find out for you – please ask them. Your doctor or nurse will also tell you about special pain medicines before they decide to start you on them.

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Will I need to take pain medicines when I go home? What happens when they run out?  How long will I need to take them for?

When it is time for you to go home after your operation, you will usually be given medicines to take home with you. The ward nurses or pharmacist will explain these medicines to you and tell you how and when to take them. Often you will be given a short supply of pain medicines to take home. If you are not given pain medicine and you feel that you need this, please let the nurses, doctors or pharmacist on the ward know. It is usual for pain after an operation to reduce every day. Some people may not need any pain medicine to take home, but others might. It is not a sign that something is wrong if you do need pain medicine – it depends on the type of operation you have had and also on your own personal circumstance.

Normally, when you leave hospital you will be given a supply of medicines to last a week. You must let your GP know if you think these are going to run out and you still need them. If pain is stopping you from coughing, deep breathing or moving, it is probably a sign that you still need pain medicine. You may not need to take the medicine all the time and it is fine for you to take it only when you feel you need it, so long as you do not take the pain medicine more often than it is prescribed. You may find that you do not need the stronger pain medicine (Tramadol, dihydrocodeine or codeine) and that paracetamol will be enough to control your pain.  Mild pain is normal after surgery, but if your pain is unusual, increases or is not getting better after you have been at home for more than a week, you should let your GP know.

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Can I drink alcohol when I am taking pain medicines?

You should be very careful when drinking alcohol with the pain medicines you are given. The link below gives useful information on this:

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Can I drive when I am taking pain medicines?

Pain medicines can sometimes interfere with your ability to drive safely. You may not realise that your pain medicine has had an effect on your ability to drive safely until you are in a situation that requires you to respond very quickly, such as an emergency stop.

Follow the below links for further information about driving when taking pain medicine:

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