Post-surgical pain occurs as a natural response to the tissue trauma experienced during surgery. Because of the hypersensitivity of the central nervous system, this pain can occur in areas other than those directly affected by the surgical procedure. Such post-operative pain may be experienced as a result of inpatient or outpatient procedures, and can occur regardless of where in the surgical spectrum the procedure falls, from a minor dental surgery to a triple-bypass heart operation.
The management of post-surgical pain can prove to be tricky for a number of reasons, chief among them being the fact that the perception of pain, the underlying attitudes and fears regarding pain, the thresholds one can tolerate, and the way in which one ultimately reacts to post-operative pain are all very subjective and personal, being specific to a given individual. As a result, any regimen directed at addressing such pain must be tailored to the individual.
Another consideration: post-operative pain increases the possibility of post-surgical complications, which in turn raises the cost of the medical care while hindering the recovery process. When pain is controlled properly, a patient realizes a number of key benefits, including the ability to more quickly participate in standard activities (like walking and eating) and the ability to receive better sleep.
One widely accepted method of administering constant pain relief involves the use of a device that delivers immediate, on demand medication to a patient (either intravenously, subcutaneously, or epidurally). The dosage of medication delivered is programmed into the device by a healthcare provider, and the patient self-administers the medication by pressing a button. With this system, referred to as patient-controlled analgesia (PCA), the patient is encouraged to maintain a steady supply of medication within his or her system, as needed. Staff members monitor the number of times the patient has called for delivery of a dosage and how effective the medication is in delivering proper pain relief.
Nonsteroid anti-inflammatory analgesics (NSAIDs) are especially useful when administering continuous, around-the-clock pain relief. These help to avoid extremes in pain perception that often occur with on-demand dosing (where a patient feels no pain and one time and extreme pain at another). Opioids are useful when administered on a specific schedule via a computerized pump.