Pain After A Hysterectomy: What You Need To Know
Pain management is a concern for all surgical patients.
There are a number of options available to manage post
surgical pain. Patients should discuss the options with
their physician prior to undergoing surgery. If you
have any allergies to pain medications such as opiates
or aspirin, you should tell your surgeon and your anesthesiologist.
If you have any underlying health issues like heart
disease, it is important to advise the surgeon and anesthesiologist.
Certain medications fro pain contain either opiates
or aspirin derivatives. Some local anesthetics, like
lidocaine can cause increased heart rate in patients
that have heart disease.
Demerol and morphine are commonly used to treat post
surgical pain. Both these drugs are derived from opium.
Side effects include mild to moderate nausea, dizziness,
grogginess and mental confusion.Some patients have severe
reactions to these medications. If you have taken either
of these drugs in the past, and suffered a reaction
to them, tell your doctor. Post surgically it is common
for patients to be provided with pumps that administer
small amounts of either morphine or Demerol on demand
to control pain.
Patients who have had adverse reactions to morphine
and demerol may be able to tolerate Toradol. This drug
is also administered intravenously with a patient controlled
pump. Toradol is an NSAID (non steroidal anti inflammatory
drug) with analgesic properties. It controls moderate
to severe pain effectively. It is contraindicated for
patients with conditions that cause bleeding, because
it has a blood thinning effect. It should not be taken
orally by patients who have ulcers.
A third option for pain relief is a thin tube placed
directly into the incision at the time of surgery. This
tube delivers a local anesthetic like lidocaine to keep
the area numb. Lidocaine is contraindicated in most
patients with heart disease as one of the side effects
can be a depressant effect on the circulatory system.
Drowsiness while receiving lidocaine can be a symptom
of a serious reaction in the central nervous system.
The tube delivering the local anesthesia is kept in
place for two days after surgery. The anesthesia is
contained in a pouch that can be strapped to the patient's
shoulder.
Following release from the hospital, patients will
be prescribed oral pain relievers to control their pain
at home. There are a large number of choices and the
doctor and patient can best decide with pain reliever
will provide the maximum pain relief with minimum side
effects. Most prescribed pain relievers have side effects
like drowsiness and dizziness. Patients on prescribed
pain relievers should not undertake potentially hazardous
activities like driving a car.
Within one month of the surgery, any discomfort should
be manageable with over the counter medications like
Tylenol, aspirin and Motrin. If the patient is still
experiencing pain that cannot be managed by over the
counter pain relievers, this is not normal and should
be reported to the doctor. Four weeks post operatively,
much of the healing should have occurred and severe
pain at that point might indicate infection or other
complications.
Controlling pain is a part of the overall surgical
strategy and should be discussed prior to surgery. Women
undergoing hysterectomies will experience different
degrees of pain depending on the type and extent of
the surgery. Some patients may experience only moderate
pain which can be controlled by non prescription pain
relievers. Other patients may have severe pain that
may last two to three weeks.
Patient and doctor should work together to insure the
patient's recovery is as comfortable as possible.
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