Nearly everyone that has surgery will have pain post-operatively. Location, type, and duration of the pain will vary from person to person. It is crucial to work with your surgeon to find the best pain management plan for you. And, it is even more important to follow through with this plan.
Several different medications can be used after surgery to help with your pain. A multimodal approach works best to help avoid the overuse of opioids. Various medicines that may be used include:
- Anesthetic Blocks
- Different types of Analgesics
- Anti-inflammatory Medications
Other natural pain-relieving modalities that should be used in addition to medication include:
Medications Used During Surgery to Decrease Pain
Historically, most significant surgeries require general anesthesia. But as we advance in medicine, we are finding that using an anesthetic block can improve postoperative pain and decrease nausea and drowsiness. Coming out of hip or knee joint replacement surgery more alert and with less pain can help start you off on an excellent path for healing. Your medical team, including your surgeon and your anesthesiologist, will work with you to decide if this is a good option for you.
Whether you receive an anesthetic block or general anesthesia, you may also receive local analgesics towards the end of your surgery. These local, soft tissue injections are provided to help begin the process of reducing postoperative pain, even before you are out of surgery.
Then, as you awaken from surgery and are awaiting discharge from the hospital, IV analgesics can also be administered to continue to help manage or decrease your pain.
Medications Used After Surgery
Once you are discharged from the hospital, it is essential to continue your pain management protocol and schedule. Most importantly, Aspirin will be prescribed daily for the first month, not just for pain relief but to be used prophylactically for deep vein thrombosis or pulmonary embolism (blood clots).
You will be prescribed an oral pain reliever, including an opioid and Tylenol. To help supplement these pain medications, you will also take an anti-inflammatory medication such as ibuprofen. Together, these medications help decrease your pain, inflammation and improve your tolerance to Physical Therapy and your rehabilitative process. More importantly, the combination of these drugs reduces your reliance on opioids, also known as narcotics.
Opioids can be addictive and can cause further problems down the road if they are overused after surgery. To help minimize this risk, your surgeon will prescribe certain medications to be taken orally daily. As a backup, other drugs will be prescribed on an as-needed basis.
Here is an example of what works well for many of our patients:
- Tylenol 650mg daily
- Celebrex 200mg twice a day or Meloxicam 15mg daily
- Aspirin 81mg daily
And, as needed:
- Tramadol 50mg for mild pain as needed
- Oxycodone 5mg for moderate pain as needed
- Oxycodone 10mg for severe pain as needed
Other Pain-Relieving Modalities
Medications are not the only thing that can reduce your pain after a joint replacement or other surgery. Cryotherapy, elevation, and compression can all provide pain control.
After surgery, cryotherapy (or the use of cold/ ice) can be applied several times a day to decrease swelling and improve pain. This is especially true after going to Physical Therapy or working on your rehabilitation exercises at home.
You should also elevate your leg while at rest. Elevating your leg above your heart will help with circulation, decreasing swelling, all while reducing pain.
Lastly, compression stockings, wraps, or the use of a compressive device can further enhance your ability to decrease swelling and pain. It is standard to be prescribed compression stockings to both legs after surgery, not only for relief but to lower the risk of a blood clot. But you may find yourself wanting to wear the stockings for longer than prescribed due to the comfort that these can provide.
When working with Dr. Morton, you can trust that we will address your pain and functional status when creating a tailored medication plan after your surgery.