Post Surgical Recovery
Top 10 Surgeries that require a post-surgical aide.
Broken Bone Repair
Heart Bypass Surgery (Coronary Artery Bypass Graft)
Inguinal hernia repair
Low back pain surgery
Post Surgical Treatment
Limit Strenuous Activity
Avoid rigorous exercise and activities that require heavy lifting for a couple of weeks to lower the chances of increasing your eye pressure. “High eye pressure can interfere with the incision before it fully heals,” says Eghrari. “Positions that put your head below your waist, such as bending over, can also increase eye pressure and should be avoided initially after surgery.”
Shield Yourself from Irritants or Trauma
“When you come home from surgery, it’s natural to feel like something is in your eye, like an eyelash or particle of sand,” says Eghrari. “The eyes can be sensitive to the environment for at least a week after surgery. Wraparound sunglasses will not only protect you from exposure to dust, dirt and pollen, but also help with sensitivity to light. Your eye doctor will also provide you with an eye shield for you to wear while sleeping during this recovery time, to eliminate touching or rubbing of your eyes.”
Keep Out of the Pool, and Shower Carefully
Exposure to water can put your eyes at risk of infection or irritation until your eye has healed from surgery. “Give yourself at least one night of sleep before showering, and prevent the stream of water from hitting your eyes directly,” says Eghrari. “Ask your doctor when it is safe to begin swimming or using a hot tub. In most cases, that will be a few weeks.”
Consult your eye doctor about when you can safely resume driving, based on your recovery. “Your world often looks brighter after cataract surgery,” says Eghrari. “You may find that sunglasses or a dedicated set of driving glasses can help to moderate the light entering the eye from bright headlights.”
Follow Doctor’s Orders
Be sure to ask your doctor about precautions you can take, such as those listed above, and proper timelines on when to resume normal daily activities. You should also contact your eye doctor immediately if you experience any of the following symptoms after your surgery:
Spots (floaters) or flashes in your vision
Nausea, vomiting or excessive coughing
“Follow the dosage instructions of prescribed medications such as eye drops or pain relievers as directed,” says Eghrari. “Each eye and each person has specific needs, so your eye doctor will provide the best directions for a successful recovery.”
3) Broken Bone Repair:
In the most common surgery to repair a femur fracture, the surgeon inserts a rod or large nail into the center of the bone. This rod helps support the bone until it heals. The surgeon may also put a plate next to your bone that is attached by screws. Sometimes, fixation devices are attached to a frame outside your leg.
What to Expect at Home
Recovery most often takes 4 to 6 months. The length of your recovery will depend on how severe your fracture is, whether you have skin wounds, and how severe they are. Recovery also depends on whether your nerves and blood vessels were injured, and what treatment you had.
Most of the time, the rods and plates used to help the bone heal will not need to be removed in a later surgery.
You may be able to start showering again about 5 to 7 days after your surgery. Ask your health care provider when you can start.
Take special care when showering. Follow your provider's instructions closely.
If you are wearing a leg brace or immobilizer, cover it with plastic to keep it dry while you shower.
If you are not wearing a leg brace or immobilizer, carefully wash your incision with soap and water when your provider says this is OK. Gently pat it dry. DO NOT rub the incision or put creams or lotions on it.
Sit on a shower stool to avoid falling while showering.
DO NOT soak in a bathtub, swimming pool, or hot tub until your provider says it is OK.
Change your dressing (bandage) over your incision every day. Gently wash the wound with soap and water and pat it dry.
Check your incision for any signs of infection at least once a day. These signs include more redness, more drainage, or the wound is opening up.
Tell all of your providers, including your dentist, that you have a rod or pin in your leg. You may need to take antibiotics before dental work and other medical procedures to reduce your risk of getting an infection. This is more often needed early after the surgery.
Have a bed that is low enough so that your feet touch the floor when you sit on the edge of the bed.
Keep tripping hazards out of your home.
Learn how to prevent falls. Remove loose wires or cords from areas you walk through to get from one room to another. Remove loose throw rugs. DO NOT keep small pets in your home. Fix any uneven flooring in doorways. Have good lighting.
Make your bathroom safe. Put hand rails in the bathtub or shower and next to the toilet. Place a slip-proof mat in the bathtub or shower.
DO NOT carry anything when you are walking around. You may need your hands to help you balance.
Put things where they are easy to reach.
Set up your home so that you do not have to climb steps. Some tips are:
Set up a bed or use a bedroom on the first floor.
Have a bathroom or a portable commode on the same floor where you spend most of your day.
If you do not have someone to help you at home for the first 1 to 2 weeks, ask your provider about having a trained caregiver come to your home to help you. This person can check the safety of your home and help you with your daily activities.
Follow the instructions your provider or physical therapist gave you about when you can start putting weight on your leg. You may not be able to put all, some, or any weight on your leg for a while. Make sure you know the correct way to use a cane, crutches, or walker.
Be sure to do the exercises you were taught to help build strength and flexibility as you recover.
Be careful not to stay in same position for too long. Change your position at least once an hour.
When to Call the Doctor
Call your provider if you have:
Shortness of breath or chest pain when you breathe
Frequent urination or burning when you urinate
Redness or increasing pain around your incision
Drainage from your incision
Swelling in one of your legs (it will be red and warmer than the other leg)
Pain in your calf
Fever higher than 101°F (38.3°C)
Pain that is not controlled by your pain medicines
Nosebleeds or blood in your urine or stools, if you are taking blood thinners
4) Intracranial surgery: Post-operative care following an intracranial surgery might not end soon in some cases; it could last for months or even for years. The caregiver should be mentally prepared for this fact and not spend all their energy right at the beginning. Also, clarify with the doctor the nature of symptoms; those which are a natural part of the recuperation process and the ones which would signal an emergency.
Immediate Post-operative Nursing Care
Accurately observe vital and neurological symptoms.
Administer eye drops in comatose patients
Maintain 30° elevation of the head portion of the patient’s bed
Monitor body temperature
Arrange for precautionary measures in case of seizures
Precisely record ingestion and output
Help the patient to cough and breathe deeply as recommended by the doctor
Perform motion exercises as advised by the doctor
Continuous communication with the patient
Periodic reorientation of the patient in terms of being, space and time.
Possible Impacts of Intracranial Surgery
The majority of the tumor or, if possible, the entire tumor is removed in the course of the surgery. Intracranial surgery might cause one or more of the following:
Temporary or permanent visual defects
Variations in cognitive abilities
Bouts of unconsciousness or slipping into a coma
Partial or complete paralysis
Anomalies in bowel or urinary bladder functioning
Modifications in normal behavior
A lost sensation of space and time
Most of these problems occur due to inflammation in and around the brain due to the delicate surgery, and they disappear with time in the majority of the cases.
In some cases, these problems can last longer, depending on the damage caused by the tumor to the functional and healthy sections of the brain.
The Right Approach
Immense patience and extreme care are needed from family, friends, and relatives to enable the patient to emerge stronger than before the diagnosis.
Several important facts need to be kept in mind while dealing with the patient’s condition post-operation.
The patient needs comfort and reassurance at all times post-surgery. Despite normal feelings of anxiety and fear, the caregivers should act strong and provide support with proper guidance and accurate information from the medical team. Never be ambiguous about any step you take, it’s always better to confirm than to guess.
Be Prepared and Gain Clarity on Facts
Post-operative care following an intracranial surgery might not end soon in some cases; it could last for months or even for years. The caregiver should be mentally prepared for this fact and not spend all their energy right at the beginning. Also, clarify with the doctor the nature of symptoms; those which are a natural part of the recuperation process and the ones which would signal an emergency.
Observe Regularity in Medication
One of the most crucial aspects of post-operative care is strict adherence to the medication regimen because deviating from it could lead to a setback or barrier to the success of the surgery.
Lifestyle and Diet Changes
Usually, post-operative care for intracranial surgery entails significant changes in the survivor’s daily living and dietary plan. Strictly follow the doctor’s instructions and teach family members to execute them in your absence.
Support groups act as a ray of hope for patients who undergo intracranial surgery, and for their families. Associating with such groups is an excellent way to learn and adopt tested measures to healthy living post-surgery.
Some individuals suffer a lasting impact such as aberrations in speech or weakness or numbness in limbs.
Though it is difficult to stay strong when the recovery period is lengthy, patients show considerable improvement with time due to continuous support and the efforts of speech therapists, rehabilitation specialists, and physiotherapists.
Gradually the patient’s confidence level increases as they approach the level of fitness they had before diagnosis.
Accompany The Patient
Family members should make it a point to accompany the patient to their regular visits to the doctor, periodic MRI, and CT scans and rehabilitation treatment sessions.
This gives the patient a sense of security, boosts their spirits and alleviates the possibility of depression.
Cheer Them Up
The best way to make sure that the patient recovers as quickly as possible is by adding cheer to their routine in various ways.
Read humorous articles to them or talk about positive things happening in life with you or other people you know.
Encourage them to stroll in the fresh air, or take them out in a wheelchair if necessary. Play music that elevates their mood or view positive movies.
Help them to see people who positively impacted their lives in the past. Being positive will definitely speed up their recovery.
Medical experts say that emerging hale and hearty from an illness requires being positive and confident, along with the medication and treatment plan.
Recovering from a hysterectomy takes time. Most women stay in the hospital one to two days after surgery. Some doctors may send you home the same day of your surgery. Some women stay in the hospital longer, often when the hysterectomy is done because of cancer.
Your doctor will likely have you get up and move around as soon as possible after your hysterectomy. This includes going to the bathroom on your own. However, you may have to pee through a thin tube called a catheter for one or two days after your surgery.
The time it takes for you to return to normal activities depends on the type of surgery:
Abdominal surgery can take from four to six weeks to recover.
Vaginal, laparoscopic, or robotic surgery can take from three to four weeks to recover.
You should get plenty of rest and not lift heavy objects for four to six weeks after surgery. At that time, you should be able to take tub baths and resume sexual intercourse. How long it takes for you to recover will depend on your surgery and your health before the surgery. Talk to your doctor..
6) Heart Bypass Surgery (Coronary Artery Bypass Graft)
After surgery, it takes 4 to 6 weeks to completely heal and start feeling better. It is normal to:
Have pain in your chest area around your incision
Have a poor appetite for 2 to 4 weeks
Have mood swings and feel depressed
Have swelling in the leg that the vein graft was taken from
Feel itchy, numb, or tingly around the incisions on your chest and leg for 6 months or more
Have trouble sleeping at night
Be constipated from pain medicines
Have trouble with short-term memory or feel confused ("fuzzy-headed")
Be tired or not have much energy
Have some shortness of breath. This may be worse if you also have lung problems. Some people may use oxygen when they go home.
Have weakness in your arms for the first month
Learn how to check your pulse, and check it every day.
Do the breathing exercises you learned in the hospital for 4 to 6 weeks.
Shower every day, washing the incision gently with soap and water. DO NOT swim, soak in a hot tub, or take baths until your incision is completely healed. Follow a heart-healthy diet.
If you feel depressed, talk with your family and friends. Ask your health care provider about getting help from a counselor.
Continue to take all your medicines for your heart, diabetes, high blood pressure, or any other conditions you have.
Do not stop taking any medicine without first talking with your provider.
If you are taking a blood thinner, such as warfarin (Coumadin), you may need to have extra blood tests to make sure your dose is correct.
Stay active during your recovery, but start slowly.
Do not stand or sit in the same spot for too long. Move around a little bit.
Walking is a good exercise for the lungs and heart after surgery. Do not be concerned about how fast you are walking. Take it slow.
Climbing stairs is OK, but be careful. Balance may be a problem. Rest halfway up the stairs if you need to.
Light household chores, such as setting the table, folding clothes, walking, and climbing stairs, should be OK.
Slowly increase the amount and intensity of your activities over the first 3 months.
Do not exercise outside when it is too cold or too hot.
Stop if you feel short of breath, dizzy, or any pain in your chest. Do not do any activity or exercise that causes pulling or pain across your chest, such as using a rowing machine or weight lifting.
Keep your incision areas protected from the sun to avoid sunburn.
Do not drive for at least 4 to 6 weeks after your surgery. The twisting involved in turning the steering wheel may pull on your incision. Ask your provider when you may return to work, and expect to be away from work for about 6 to 8 weeks.
Do not travel for at least 2 to 4 weeks. Ask your provider when travel is OK. Also, ask your provider before starting sexual activity again. Most of the time it is OK after 4 weeks.
You may be referred to a formal cardiac rehabilitation program. You will get information and counseling regarding activity, diet, and supervised exercise.
For the first 6 weeks after your surgery, you must be careful about using your arms and upper body when you move.
Do not reach backward.
Do not let anyone pull on your arms for any reason -- for instance, if they are helping you move around or get out of bed.
Do not lift anything heavier than 5 to 7 pounds (2 to 3 kilograms).
Do not do even light housework for at least 2 to 3 weeks.
Check with your provider before using your arms and shoulder more.
Brushing your teeth is OK, but do not do other activities that keep your arms above your shoulders for any period of time. Keep your arms close to your sides when you are using them to get out of bed or a chair. You may bend forward to tie your shoes. Always stop if you feel pulling on your breastbone.
Your provider will tell you how to take care of your chest wound. You will likely be asked to clean your surgical cut every day with soap and water, and gently dry it. Do not use any creams, lotions, powders, or oils unless your provider tells you it is OK.
If you had a cut or incision on your leg:
Keep your legs raised when sitting.
Wear elastic TED hose for 2 to 3 weeks until the swelling goes away and you are more active.
When to Call the Doctor
Call your provider if:
You have chest pain or shortness of breath that does not go away when you rest.
Your pulse feels irregular -- it is very slow (fewer than 60 beats a minute) or very fast (over 100 to 120 beats a minute).
You have dizziness, fainting, or you are very tired.
You have a severe headache that does not go away.
You have a cough that does not go away
You are coughing up blood or yellow or green mucus.
You have problems taking any of your heart medicines.
Your weight goes up by more than 2 pounds (1 kilogram) in a day for 2 days in a row.
Your wound changes. It is red or swollen, it has opened, or there is more drainage coming from it.
You have chills or a fever over 101°F (38.3°C).
7) Inguinal hernia repair
Recovery Time After Hernia Surgery
Recovery time after surgery depends on the type of hernia you have and the type of procedure required. Patients who undergo minimally invasive surgery are usually able to go home the same day and are able to walk the night of the surgery. Some patients, especially those who have had abdominal wall reconstructions or component separations, may have to stay in the hospital for a few days.
Discomfort After Hernia Surgery
Discomfort is typically handled with over-the-counter medication, although some patients may require a combination of over-the-counter and opioid-based medication.
Follow-Up Appointments After Hernia Surgery
All patients need a follow-up appointment two weeks after surgery to ensure that their pain is well controlled and there are no infections. Patients with more complex procedures may have complex bandages or negative pressure dressings that need evaluation, and we need to ensure that any surgical drains are performing properly to avoid infection. Depending on the patient’s progress, a second follow-up appointment may be necessary.
After surgery, most patients will be asked to avoid lifting anything heavier than 15 pounds for the first two weeks, though more complicated patients may have differing limitations. Different patients will have individual restrictions, but in general, you should be as active as your provider permits. If you have any questions or health concerns after your surgery, contact your provider right away.
Advances in technology and medical knowledge have lowered the risk of complications after hernia surgery substantially, and our experts use the latest practices and equipment to provide the safest procedures possible. However, there is still a chance of recurrence or infection after surgery. Obesity and smoking increase these risks substantially, and many hernia experts will require patients to lose weight and commit to smoking cessation before surgery, unless tissue is incarcerated or strangulated. Additionally, activities that increase intra-abdominal pressure at the hernia repair site should be avoided, as even a persistent cough or constipation can increase the risk of recurrence. Chronic pain is also a risk. Although most pain will go away with conservative management, in rare cases, further surgery may be necessary to alleviate the pain. A healthy lifestyle with regular exercise and regular checkups with your primary care provider will also help reduce the risks involved with any surgery.
8) Low back pain surgery
Plan to rest for the first 24-48 hours following discharge from the hospital.
Avoid excessive bending, twisting, pushing, pulling, or lifting anything more than 10 pounds for the first week.
Avoid sitting or standing for more than 30 minutes at a time for the first week.
If you need to pick something up from ground level, squat and keep your back straight.
If you were fitted with a brace, please wear it for most of the day when you are active for a total of 6 weeks. You may remove it at night, for showers/baths, and when you are relatively inactive around the house.
Your TED hose may be removed 1 week after surgery.
Incision care and dressings
Please change your dressings with sterile gauze once a day until your wound is completely dry (i.e., when there is absolutely no drainage on the dressings).
Although you may start taking showers when your wound is completely dry (approximately 3-5 days), do not keep your incision submerged in a bathtub until the wound is healed over (approximately 2 weeks).
If you have Steri-Strips on your incision, allow them to fall off on their own.
If you have Dermabond (“sterile super glue”) on your incision, it will likely begin to peel off by itself after 1-2 weeks.
You may apply an ice pack to the surgery site for 20 minutes three times a day for comfort and to reduce swelling.
You may resume your normal, pre-operative diet as tolerated.
Pain medications and decreased activity can cause constipation. To prevent this, eat foods high in fiber and drink 6-8 glasses of water per day. If needed, take an over-the-counter stool softener if one was not prescribed for you. Your bowels should be working normally within 3-5 days of surgery.
Foods high in protein and vitamin C can also aid the wound healing process. Please take 500mg of oral vitamin C twice a day for 3 months to aid in the wound healing process.
If you had a fusion, your diet should contain 1,000-1,500 mg of calcium daily to optimize conditions for adequate fusion. If you are not getting enough calcium in your diet, you should take 1,500 mg of oral calcium every day. Please check with your physician if you have a history of kidney stones.
9) Partial Colectomy
Recovery from colectomy is going to depend largely upon the patient's health prior to the surgery. There are a number of factors that contribute to how quickly someone is back up and running after major surgery. If possible, talk to the doctor beforehand to learn what you should expect. The doctor should be able to estimate their recovery time and help you prepare for your loved one's homecoming. If your loved one has an extensive medical history or a history of diabetes, lung disease, or heart disease, their post-operative recovery might take a little longer than the average healthy adult. The factors used to determine how quickly someone will recover include:
A history of medical conditions (aside from the colon cancer)
Lifestyle (Do they smoke cigarettes? Exercise?)1
Like most major surgeries, there are risks and potential complications associated with the colectomy. And while none of them are routine, the most common complications include:
Bleeding and infection
Intestinal blockages (in the small intestine if scar tissue develops)
Problems with the surgical wound
If complications do occur, the patient's hospital stay and increase their overall recovery time. They also might need more assistance when they come home. For instance, if a surgical wound infection occurs, your loved one's surgeon will most likely suggest homecare nurses to come and help you care for the wound until it has healed.
Things that many people take for granted, such as showering, moving around, and using the restroom, become a challenge following abdominal surgery. If they have a split-level or two-story home, it may be difficult initially for your loved one to ambulate up and down the steps to shower, rest, or go to bed. If you have a ground floor room available — preferably very close to a bathroom — that is best. Following a colectomy, most people will have up to six bowel movements per day. It might help your loved one conserve energy if they have access to, or can rent, a bedside commode for a few weeks.
If you are concerned about your postoperative outcome, there are a few steps that can help to prevent complications. Make sure that you consult your doctor before making any modifications to your care routine.
1. Follow your plastic surgeon’s advice
When it comes to a fast smooth tummy tuck recovery, the last thing you want to do is be one a patient who does everything but what your surgeon advises. Quite simply, if you follow this course you’ll dramatically increase your risk of complications.
“Occasionally, patients will certainly engage in activities that slow their recovery or cause complications. Probably the most impactful factor is not following the surgeon’s instructions. This is a big one,” says Jack. “We make postoperative instructions for a reason — to protect the patient and help ensure they heal well and have a good cosmetic outcome.”
2. Arrange for a helping hand
“It’s very important to have a good support network and make sure that you have help post-surgery,” says Taglienti. “For those who plan to undergo a tummy tuck, having an extra pair — or extra pairs — of hands is immeasurable.”
Lee agrees, saying, “I highly recommended you have someone to stay with you for at least 24 to 48 hours after your procedure. You won’t be able to stand straight for a time after your tummy tuck so you will need some help doing simple tasks like getting out of bed, removing garments and showering. Although you may not feel like getting out of bed, you’ll be encouraged to get up at least two to three times a day and move around, as this helps increase circulation.”
3. Set yourself up for comfort and rest
You need to ensure that you get adequate rest, “for comfort when lying down, rest in bed with two or three pillows behind your head and a pillow under your knees,” says San Diego plastic surgeon Dr. Gilbert Lee. “Get out of bed by sitting up first, then moving your legs over the edge of the bed, and then standing from there. This is when you might need to rely on your caretaker for the first day or so — to help you out of bed.”
4. Focus on quality nutrition
“Believe it or not, patients who are overweight are malnourished. What that means is that their capacity to heal is very poor,” says Grossman. “Patients who are malnourished have more seromas or fluid accumulations. In fact, about 50% of all patients will form a seroma when not stabilized nutritionally. So, at my practice we have an extensive approach to nutrition before and after the surgery.”
On top of eating a healthy diet, Lee suggests that certain foods can help you heal faster. He recommends dark leafy greens along with pineapple and vitamin C-rich foods. Foods that might cause gas, such as cabbage and beans, should be avoided.
Also, stay away from foods that are excessively salty, eat small portions, and drink lots of water to make sure you stay hydrated.
» Learn more about the best pre and post surgery diet to ensure a safe procedure and fast recovery.
5. Quit smoking
“Since many blood vessels are cut during a tummy tuck procedure, wound healing can be compromised in some areas of the abdomen. This becomes a more serious issue in smokers because the vessels that remain can suddenly close, with sometimes detrimental results,” says Grossman. “It is absolutely essential that patients quit smoking for at least four to six weeks prior to surgery so it does not affect their recovery.”
6. Move your body, but not too much
“We want you up walking right away after surgery,” says Jack. “This is crucial because it’s the most effective way to reduce risk of blood clot formation. It will also help keep your body from becoming stiff and tight, keep the tissues soft and relaxed, and will speed along resolution of swelling. On the flip side though, don’t do too much, too early.”
You need to avoid heavy lifting and strenuous activity and allow yourself enough time to get the sleep and rest your body needs during it’s healing process. “Lack of sleep will increase your cortisol levels and impair healing,” adds Jack.
7. Take at least two weeks off work
“Ensure that you take adequate time off from work,” says Taglienti. “For most people, this means two weeks. Granted, everyone heals differently, but if you take a full two weeks to rest after surgery, you will not feel as sore and tired when you return to work. Patients who do not give themselves a chance to heal properly can cause needless tension on the wound, and impede wound healing.”
8. Follow your surgeon’s advice
Yes, we have mentioned this already, but it is very important and worth mentioning again. Your surgeon will give you the best advice on how to heal, recover, and avoid complications. It’s absolutely essential that you “follow your surgeon’s specific instructions,” says Jack.
Before surgery you will likely have a discussion with your surgeon or other members of your care team about pain management, treatment options and your particular needs. This conversation may include the following ideas:
Pain expectations. Ask your doctor about pain typically associated with the procedure and the expected duration of recovery.
Previous experiences with pain. Talk to your doctor about your experience with pain and different methods of pain control. Mention what has worked for you and what hasn't in the past.
Chronic pain. If you take drugs to treat chronic pain, your body may be less sensitive to pain medication. Your doctor will discuss options for treating both chronic pain and post-surgical pain.
List of your medications. Include all prescription and over-the-counter medications plus any supplements or herbs you've taken in the past month. Your doctor needs to know about anything that might interact with post-surgical pain medications. You may need to change your drug regimen before and after surgery.
Alcohol and drug use. Accurately describe your current use of alcohol, tobacco or illicit drugs. Your doctor needs to know if you are recovering from an addiction to — or currently misuse — alcohol or drugs, including prescription medications, in order to plan and monitor your pain management.
Side effects. Ask for written information about the drugs you will be prescribed and their side effects. Ask questions about what can be done to minimize side effects and when to get help for serious side effects.
Additional pain management. Ask your doctor about interventions that may support your treatment plan, such as psychobehavioral interventions to address anxiety or coping skills.
Discussion of your concerns. If you're afraid of side effects or overdosing on pain medications, talk to your doctor. He or she can help you understand strategies to safely manage your pain.
Types of pain medication
Post-surgical pain is usually managed with multiple pain-reducing medications (analgesics). The appropriate type, delivery and dose of medications for you depend on the type of surgery and expected recovery, as well as your own needs.
Pain medications include the following:
Opioids, powerful pain medications that diminish the perception of pain, may be given after surgery. Intravenous opioids may include fentanyl, hydromorphone, morphine, oxycodone, oxymorphone and tramadol. Examples of opioids prescribed in pill form after surgery include oxycodone (OxyContin, Roxicodone, others) and oxycodone with acetaminophen (Percocet, Roxicet, others).
Local anesthetics, such as lidocaine and bupivacaine, cause a short-term loss of sensation at a particular area of the body.
Nonsteroidal anti-inflammatory drugs (NSAIDs) — such as ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, Anaprox, others), celecoxib (Celebrex) or ketorolac — lessen the inflammatory activity that worsens pain.
Other nonopioid pain relievers include acetaminophen (Tylenol, others) and ketamine (Ketalar).
Other psychoactive drugs that may be used for treating post-surgical pain include the anti-anxiety medication midazolam or the anticonvulsants gabapentin (Gralise, Horizant, Neurontin) and pregabalin (Lyrica).
While opioids may or may not be appropriate to use after your surgery, your surgeon will likely prescribe a combination of treatments to control pain, lessen side effects, enable you to resume activity appropriate for recovery and lower risks associated with opioids.
Managing the risks of opioid use
Opioids are often critical for post-surgical pain management because of their powerful effect. But their side effects can be significant, including nausea, vomiting, constipation, urinary retention, drowsiness, impaired thinking skills and poor respiratory function.
Overdosing and misuse of opioids also are risks, particularly when opioids are used to treat ongoing (chronic) pain. Although the use of opioids after surgery is intended as a short-term strategy to relieve pain while the body heals, the risk of misuse is still a concern.
Because of the risks associated with opioids and their potential side effects, these drugs should be used carefully, if at all. Opioids should be used at the smallest dose effective for the shortest possible time.
You and your doctor should discuss steps you can take to reduce the risks associated with opioid use, including:
Taking medication only as directed, minimizing dose and length of opioid use
Talking to your doctor when your pain is not under control
Not using alcohol while taking opioids
Following your doctor's instructions about other drugs not to take while using opioids
Storing drugs safely
Disposing of unused drugs, ideally through a pharmacy take-back program
Not sharing your medication with other people
Pain relief after major surgery
A primary goal of pain management after major surgery is for you to awaken relatively comfortable and to experience an uninterrupted transition to pain control, but some discomfort is common and should be anticipated after surgery.
Intravenous (IV) pain medication
Before surgery, you'll probably have a slender plastic tube (catheter) inserted into a vein in your hand or arm to give you fluids, sedatives, anesthetics, antibiotics or pain medications. The catheter can be used for delivering pain medications until you can take pills by mouth.
Pain relievers, such as opioids, are usually injected into your IV catheter at regular intervals. Most hospitals also offer patient controlled analgesia (PCA) — a system that allows you to give yourself a fixed dose of the medication by pushing a button. This way you don't have to ask a nurse for each dose of pain medicine.
The PCA system has built-in safeguards to prevent you from overdosing on pain medication. If you push the button more than once within a set period of time, the dispenser ignores the second request.
In epidural analgesia, pain medications are injected through a catheter inserted into the epidural space within your spinal canal but outside your spinal fluid. An epidural catheter is often used for labor and delivery, and sometimes before an operation, such as a cesarean section or a major abdominal surgery.
The epidural catheter can be left in place for several days if needed to control postoperative pain. A continuous infusion of pain relievers, including local anesthetics or opioid medications, can be delivered through the catheter to control pain.
Patient controlled epidural analgesia (PCEA), similar to PCA, enables you to give yourself a dose of the pain medication by pushing a button. It, too, has built-in safeguards so that you don't give yourself too much medication.
Some surgeries can be done with spinal anesthesia, which involves medications injected directly into the spinal fluid.
Spinal anesthesia is easier and faster than epidural analgesia is, but it doesn't last as long because there's no catheter to allow the administration of additional medication. Your doctor can add a
long-acting opioid to the spinal medication that can relieve post-surgical pain for up to 24 hours.
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