Acute Pain Management PDF Print E-mail

After your surgery, your surgeon usually will prescribe IV or oral pain medicine to control your pain. Sometimes your surgeon will ask American Anesthesiology's physicians to provide acute pain management services to you during and immediately following surgery. Pain control after surgery plays a role in the recovery process. Crucial activities such as taking deep breaths, getting out of bed and walking can be difficult without proper pain control thereby slowing the recovery process. Inactivity following surgery can lead to recovery complications such as pneumonia or blood clots. Our physicians are able to deliver to you many techniques that can help you achieve high levels of comfort and safety following surgery. We realize that each patient has different pain thresholds and the degree of pain will vary from patient to patient. One patient may benefit from a specific technique or procedure whereas another patient may not obtain adequate pain relief with that same technique. Our physicians tailor treatment approaches for each individual patient based on the procedure that they will undergo and the most appropriate technique to provide maximum pain relief. Various techniques to control your pain include oral medicines, IV pain medicine, nerve blocks (single-shot or continuous), continuous epidurals, spinal blocks and rarely narcotic infusions. 

 

Intravenous Patient-Control Analgesia (IV PCA)

Your surgeon usually prescribes this pain modality if you are to stay overnight in the hospital to recover from your surgery. With the Intravenous Patient-Control Analgesia (IV PCA) pump, you will have greater control over your pain. Your surgeon will write an order spelling out settings he or she would like you to have to control your pain. The pump may be programmed to give you a small amount of continuous medicine to assist in your pain relief. The pump will also allow you to increase the delivery of pain medicine, within pre-set limits, by pushing a button. This technique allows for a smoother, more immediate pain control unlike waiting for your nurse to bring you either oral or IV pain medication. We find that many patients will require much less total medicine with a pump because they can control doses as needed. Please refer to our animated narrative that demonstrates how an IV PCA would be administered to you.

 

Regional (Peripheral Nerve Block) Anesthesia

American Anesthesiology's physicians may offer various peripheral regional nerve blocks to provide the anesthesia for the procedure or in this case for post-operative analgesia. During regional analgesia, we target a specific area of the body (usually your shoulder, arm, wrist, hand, leg, ankle and foot.) for pain relief. For these procedures, your anesthesiologist will place a needle near the nerve(s) that supply the affected area and then inject a local anesthetic. These techniques may be done under ultrasound guidance, nerve stimulation or various landmarks to accomplish the block. Your anesthesiologist will usually give you sedation prior to the block placement. Please refer to our various animated narratives that demonstrate how the various blocks would be administered to you.

 

Epidural Analgesia

Epidural analgesia delivers a mixture of local anesthetic medication and narcotics continuously to nerves within the epidural space in your upper or lower back. Please refer to our animated narrative that demonstrates how an epidural would be administered to you. Once the epidural is secured in place we may attach the catheter to a pump that continuously administers a small amount of anesthetic that will maintain the pain relief or we may wait until after your surgery is complete. The pump will be programmed to give you a small amount of continuous medicine to assist in your pain relief. The pump will also allow you to increase the delivery of pain medicine, within pre-set limits, by pushing a button. This control is similar to the dosing mechanism of an IV PCA. This technique is called patient-controlled epidural analgesia, or PCEA. This type of pain control is particularly well suited for thoracic or chest surgery, major lower extremity procedures such as a total hip or knee replacement, and a number of abdominal or pelvic surgeries.

 

Spinal Analgesia

Spinal anesthesia delivers a local anesthetic medication and frequently a long acting narcotic which bathes the nerves within the subarachnoid space in your lower back. Please refer to our animated narrative that demonstrates how a spinal would be administered to you. The long acting narcotic allows for some degree of pain relief in the immediate postoperative period. Your surgeon will prescribe IV or oral medications to provide pain relief when the spinal narcotic begins to lose effectiveness.

 

Risks of Regional Anesthesia

As you are probably aware all medical procedures carry with them a certain degree of risk. Please refer to American Anesthesiology's anesthesia consent found on our website to review pertinent risks to regional anesthesia. Even though special precautions are taken by our physicians and crnas to minimize the risk associated with carrying out regional blocks, there is still a minimal amount of risk to you that still remains. Complications do not occur often and rarely lead to significant problems. Our anesthesia team will discuss these risks with you and try to answer any other questions you might have at any time.

 

Questions

The physicians of American Anesthesiology are always available to answer any questions you might have concerning your care. If there is time available prior to your surgery, then your surgeon can arrange a consultation with us if necessary. American Anesthesiology and its physicians look forward to helping you and your family get through what can be a difficult time for both your family and yourself.