Pain Management

Pain Management - What it is

Pain is a common symptom experienced by people of all ages. Not all patients admitted to the hospital have pain. You may experience different levels of pain when you have a painful condition or recovering from surgery. We aim to reduce your pain as you recuperate. Good pain relief is important as it decreases suffering and helps you to get well quickly. When you have adequate pain relief, it

Minimises interferences with activities e.g. rest and sleep
Enables you to do your physiotherapy exercises leading to speedy recovery

Pain Management - Diagnosis

Pain Relief
Depending on the level of pain, the dosage of pain relief medications can be adjusted or increased, given more often or given in different combinations.

The nurse will ask you to rate your pain on a scale between 0 – 10, both at rest and on movement. (0 = no pain, 10 = worst pain ever). This will help us to assess the effectiveness of your pain relief.

Benefits of good pain relief

You will enjoy greater comfort while you heal.
With less pain, you can be more active, start walking, do deep breathing exercises and get your strength back quickly.

A patient, whose pain is well controlled, usually does better after surgery. Problems such as chest infection and deep vein thrombosis (DVT – formation of blood clots in the legs) may be avoided.

It is much easier to relieve pain if it is dealt with before it gets unbearable. You should ask for your pain relief as soon as you feel pain and continue the treatment regularly.

Pain Management - Treatments

Ways to relieve pain

Pills, tablets or mixtures
These medications are used for all types of pain. These take at least half an hour to be effective and should be taken regularly. You need to be able to drink and not vomit for these medications to work.
Injections
Injections are often needed and are administered into your arm or thigh muscle. Injections given into the muscles may take up to 20 to 30 minutes to be effective. Occasionally, an injection may be given below the skin (sub-cutaneous).
Suppositories
These waxy bullet-like pellets are placed in your back passage (anus). When the pellet dissolves, the drug is absorbed into the body. They are useful in you cannot eat and drink or if you are likely to vomit. They are often combined with other methods of pain relief.
Patient Controlled Analgesia (PCA)
PCA is a technique which allows small amounts of pain relief to be administered through your drip using a machine. When in pain, you need to press the button on the handset. A small amount of the pain medication will go into your bloodstream to relief your pain.

By using this method, you are in greater control of your pain. There is no need to call a nurse. However, our nurses can be called for assistance at any time you need them.

You are not likely to overdose the medication as a result of using this machine. It is set such that once a safe amount of pain medication is delivered, an additional dose cannot be given within a pre-set time limit.

To make the best use of your PCA, it is advisable to press the button about five minutes before movement such as
- Sitting up in bed
- Getting out of bed
- Before deep breathing
You can use as much or as less as you want. When the effect of the pain medication wears off, you may need to give yourself more doses to remain comfortable. Please inform the nurse if you feel any discomfort in your arm.

Note: Do not allow children or other visitors to press the button on the handset.
Epidural Analgesia
The nerves from your spine and lower body pass through an area in your back close to your spine, called the ‘epidural space’. The anaesthetist will inject local anaesthetics through a fine tube called an epidural catheter into this epidural space before your surgery. As a result, the nerve messages are blocked and you will feel numbness. The numbness will gradually subside. Epidurals can be used during and/or after surgery for pain relief.

Benefits of epidural
- Better pain relief than other methods, particularly when you move.
- Reduced complications of nausea and vomiting, blood clotting in the leg or lungs, chest infection and delayed bowel function.
- Quicker return to drinking, eating and full movement, possibly with a shorted stay in the hospital.
Side effects though common, are often minor and usually easy to treat. Serious complications are fortunately rare. Your anaesthetist will discuss any possible side effects or complications with you prior to commencing the treatment.

Common side effects

Side effects of pain relief medications given through the spine, epidural space and muscle include:

Itchiness of the face and body
Shivering
Nausea and vomiting
Feeling lethargic
Difficulty in urination
Constipation

If you experience these side effects or any other discomfort, please inform our nurses so that they can help you.

Some people are worried about using morphine or morphine-like drugs as a pain relief. It is very rare for anyone to be addicted when these drugs are used for pain relief for a short period.

On discharge
You may be given pain relief medicines to take home. Continue to take your medications as directed. Some pain following a surgery is expected. Pain usually settles as the surgical wound heals. When you are feeling more comfortable, you may begin to reduce the dose and frequency of your pain medication. If the pain is not relieved or gets worse, consult your doctor.