What is a Pain Management Service? Can’t my surgeon give me pain medicine?
A Pain Management Service is a group of specialized doctors and nurses knowledgeable in the treatment of pain. Anesthesiologists often specialize in pain management because they spend a large amount of time involved in the treatment of pain in the operating room and recovery room. While surgeons routinely order medications for the treatment of postoperative pain in their patients, some patients require additional or different methods other than those used routinely by the surgeon. Patients with multiple allergies, a history of chronic pain, or other major medical conditions are examples of patients that may benefit from the services of a Pain Management Specialist. A Pain Management Service can offer additional options to treat pain, such as epidural analgesia, that may not otherwise be available.
What information is important for the doctor and nurses to know in order to assist me in formulating my pain management plan?
It is very important to tell your doctor and nurses the following information:
- Type of pain you’ve been experiencing and what medications you are taking.
- Amount of alcohol intake.
- Medications taken for sleep or anxiety
- Any use of recreational or street drugs
Can I take the pain medicine I’ve been taking at home in the hospital?
Do not take ANY medications on your own in the hospital.
Will I get "hooked" on my pain medicine?
While it is not unusual to develop a tolerance to pain medications over a period of time, studies show that development of addiction to pain medication is very rare - unless you already have a problem with drug or alcohol abuse.
I don’t like that "spaced out" feeling. Do all pain medicines have this side effect?
All patients are different when it comes to tolerance of pain and the medications given to treat it. While many pain medications have the side effects of drowsiness and dizziness, often, the dose can be adjusted to decrease these effects.
Can’t you just knock me out for about three days?
The goal of any pain therapy should be for the patient to be comfortable, but not necessarily pain - free. While it is normal for a postoperative patient to need more sleep, it is not normal or desired for the patient to sleep all the time. It is important to move about in order to prevent possible blood clots or pneumonia.
I don’t think my family member will understand how to use that little button for pain medicine. Can I just push it for him?
The Patient Controlled Analgesia (PCA) button on an IV or epidural pain medicine infusion should only be activated by the patient. It is potentially unsafe for another person to give the patient additional doses, especially if the patient is sleeping. If you are concerned that the patient is unable to use the dose button, please speak to the doctor and nurses.
How long will I have my IV PCA or Epidural?
IV PCA and epidural analgesia are usually used for 2 - 3 days or until the patient is able to take analgesics by mouth.
How do I tell the doctors and nurses about my pain?
Pain is a totally subjective experience that can only adequately be described by the patient. To make this description more meaningful to doctors and nurses, you may be asked to use a "pain scale". These are usually numerical or descriptive scales:
The goal is to stay on the low end of the scale, not to be pain-free.
Is there anything else I can do for my pain in addition to taking medications?
There are many non-drug therapies available. Simply changing position can often bring considerable relief. Applying heat or cold to the incision, if ordered by your physician can be of comfort. One of the easiest, but often overlooked pain management techniques is the use of distraction. Distraction is a kind of sensory shielding, i.e., the patient shields himself from the sensation of pain by increasing other sensory input. Turning the TV on, reading a book, listening to the radio, or visiting with a friend can actually provide a great deal of pain relief to patients. This is not to imply that the pain is in the mind, but rather that the mind is a powerful tool - use it!
While you are expected to have pain following a surgical procedure, the pain should not be such that you cannot sleep, eat or move about. If it is, tell your nurse!
Contibuting Author: Peggy Phillips, R.N.