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Pain Management Strategies to Enhance Your Recovery After Orthopedic Surgery
By Daniel Casciato

Quoted in this article were Heather Towers, DNAP, chief CRNA, and Daniel Ripepi, MD Anesthesiologist at Advanced Surgical Hospital, a physician-owned hospital, in Washington, PA.

For many people who undergo a surgical procedure, pain management is not only part of their overall treatment plan but it is their main concern. Managing pain after surgery can be simple or complex depending on the patient and the specific type of surgery.

The first step in the pain management process is evaluating a patient’s pre-surgery pain and setting realistic expectations for their pain control after surgery. At Advanced Surgical Hospital, patients who are having major surgeries that will require an overnight stay in the hospital are often evaluated in person several days or weeks before their surgery. The care team will also perform a complete health evaluation in order to tailor a pain management approach for each patient. A thorough evaluation is performed and a multimodal approach to their pain management is tailored to that patient. For patients undergoing outpatient surgery, their history is reviewed before the day of surgery and their anesthetic and pain control regimen is discussed before the surgery is performed.

Most patients will experience some degree of pain after any surgery. Our team works with the patient to determine the best approach for pain control during and after surgery. Our goal is that patients can perform activities of daily living after surgery with the least amount of pain possible. This doesn’t necessarily mean patients will be running marathons or doing strenuous exercises immediately, but they should be able to perform the daily activities they could perform before surgery. Patients should understand they will experience some pain after surgery, which is not necessarily bad. Pain itself is the body’s way of limiting your movement and helps to guide recovery.

Our entire team will work with you to decide the best approach for your pain. The standard approach to controlling pain after surgery is to try many different medications and efforts in small amounts rather than relying on one medication to control all of your pain. This allows us to use different types of pain medications that complement each other to help reduce pain in different ways. For most patients, rest and ice are where we start to help control pain and inflammation.

Most patients will require some form of pain medicine after surgery such as Tylenol or Advil. Also, many people will need some stronger medication in the short term for pain relief, including narcotics. Some patients may have concerns about using narcotics to control pain after surgery. Our team’s goal is to minimize narcotic use, when appropriate, while assisting with patient comfort. This approach to pain management is very effective at controlling pain while at the same time limiting the side effects of high doses of any one pain reliever.

An additional and more specialized way we reduce postoperative pain for patients is with nerve blocks—the injection of local pain reliever near specific nerves that helps to decrease a patient’s pain after surgery. Nerve blocks are extremely helpful in significantly reducing pain. You and your surgery care team will determine if it is the right option for you. With nerve blocks, patients have less pain and require less pain medication. As a result, patients have less chance for side effects to pain medications.

Lastly, a patient’s past medical history is always an important consideration in tailoring any pain management plan. The entire team takes the patient’s medical history and situation into consideration when determining the treatment plan. The team will consider whether the patient is taking other medications or if the patient suffers from other medical problems. For example, patients who have poor kidney function or kidney failure may not be able to use certain kinds of over the counter pain relievers after surgery. The team also considers the patient’s expected mobility and function after surgery. For example, patients who cannot bear weight on an arm or leg due to surgery may be good candidates for a nerve block.

When it comes to reducing pain after surgery, our goal is always to create a plan for each individual patient that helps them recover quickly and with as little pain as possible.

For more information, visit https://ashospital.net/

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