Pain control during and after surgery is one of the most common concerns of joint
replacement patients. With today's pain management techniques you should be kept comfortable.
Anesthesia During Surgery
Anesthesia is the loss of sensitivity to pain brought about by various drugs known as anesthetics. There are several types to choose from. Your anesthesiologist will discuss the one best suited for you.
General anesthesia was the most common form of anesthesiology for many years. The patient is put into a deep sleep and will not feel any sensation.
Spinal or epidural anesthesia targets a specific area, like a joint, and totally numbs it. Although you are awake, you do not feel pain. Typically with spinal or epidural anesthesia another medication is administered to make you very relaxed and enter a light sleep state. As with general anesthesia, you will not remember the surgery.
Post-Op Pain Control
There are several different types of pain control methods available that will keep you comfortable and allow you to be up and walking shortly after surgery. Your doctor will choose the method right for you based upon your medical history, the amount of pain you are having and your phase of recovery.
- Oral medications are often used to control pain. These may be administered prior to surgery to get a start on pain control and may be continued throughout your hospital stay. Most likely you will be given a prescription for oral medication to use after discharge.
- A nerve block is sometimes an effective method of pain control used for total knee replacement. Basically, a local anesthetic is injected into or near the femoral nerve in the thigh. Nerve blocks prevent the pain signals from reaching the brain. Consequently you feel no pain.
- Pain medications can be given intravenously through a vein in the arm. The IV method can be used with a PCA pump. The pump can be regulated to provide a continuous supply of pain medication. If you begin to feel uncomfortable, simply press the button on the pump and it will deliver a booster dose of pain medication. The pump has safety features to ensure that the correct dosing is delivered with no threat of overdosing. After you push the button, simply relax and your discomfort will be gone shortly.
- Other types of pain pumps can be used to deliver an anesthetic agent directly into the joint. Like the PCA, you can control the dosage.
It is important for you to tell your healthcare team if the pain medication is not sufficient, if you feel nauseous or if you are not as alert as you feel you should be. Adjustments can be made.
Prevent the Pain Cycle
Pain has a cycle. It begins and increases until medication interrupts it. The aim of good pain control is to stop pain before it becomes intolerable. If you begin to feel the pain increasing, activate the PCA, or if you are not on a PCA, call the nurse and request medication. This is one time that you do not want to tough it out. If the pain cycle takes hold, it will be harder to control.
You will be asked to use a pain scale to help describe your pain level. If "0" means no pain and "10" is the worst pain possible, how would you rate the pain level? To relieve your pain most effectively, your healthcare team needs to know how well pain relief measures are working for you. Medications can be adjusted to meet your needs.
Other Methods to Decrease Pain
It is most important to try to relax after your surgical procedure. When you are relaxed, pain medications work better. You can also position yourself for comfort and ease of breathing. Applying ice to the area for 15-minute intervals may help.
CAUTION! If you have a nerve block fo rpain control DO NOT GET UP ALONE!