The article was written by Specialist Doctor II Nguyen Thi Hoai Nam – Head of Pain Relief Unit, Surgical Anesthesisitics Department – Share99 Central Park International Health Hub.
Surgery is a stress both psychologically and physically for the patient. In addition to worries, insecurity about his own disease and the results of surgery, the patient's primary concern is pain and pain relief after surgery. To help patients accept and gently overcome this challenge, it is necessary to provide them with things to know about pain and relieve pain after surgery.
1. Pain classification
Pain by definition is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or a description of that damage.
Pain classification: Pain classification is useful in the evaluation and treatment. There are many ways of classification of pain.
Classification by erm:
- Nociceptive: Pain caused by pain, manifestations of normal response of the body when tissue is injured or damaged such as skin, muscles, organs, joints, tendons, bones.
- Neuropathy: Pain associated with a minor lesion or nervous system pathology
- Pain caused by inflammation such as appendicitis, arthritis…
By intensity: usually take a pain scale of 0-10 in which 0 – painless, 10 – pain does not tolerate:
- Mild pain: 0-4 points
- Moderate pain: 5-6 points
- Pain: 7-10 points
- Emergency pain: Pain lasts less than 3-6 months
- Chronic pain: Pain lasts more than 3-6 months, which can be a persistent process of emergency pain or pain after surgery that has healed the wound
- Exacerbates of chronic pain
Post-surgery pain is considered an urgent pain that the patient feels as soon as the effects of anesthesia or anesthesia are used in surgery. It is a combination of sensory, emotional and mental unpleasant sensations combined with automatic, end of endal and variable reactions, psychological and behavioral responses to scientific lesions. The mechanism of post-surgery pain is complex, pain caused by pain receptors combined due to inflammation, organs and neurological pathology.
Is post-surgery pain terrible? If not properly evaluated and treated, this is a scary problem. However, do not worry, the anesthesi will always accompany you to minimize the pain after surgery. The treatment of pain is started before, during and after surgery. Upon pre-anaesthetic examination, the anaesthesi doctor will prepare psychologically and take pre-anesthetic according to the regimen.
Depending on the type of surgery, the doctor will choose the method of anesthesia or anesthesia which means that you will take anesthesia and/ or anesthesia to ensure that when operating the patient will no longer feel pain and decrease or lose consciousness. Painkillers are also taken in coordination before the operation ends to prevent post-surgery pain. In the rehabilitation room, patients will be monitored for signs of survival and assessed the level of pain periodically, thereby being treated for appropriate pain. Treatment of post-surgery pain will be maintained until discharged and sometimes even after discharged.
2. Why treat post-surgery pain?
Pain is the subjective feeling of each person. The same type of surgery (the same level of pain) but with one person can be only mild pain, the other feels moderate pain or unbearable pain, since each person may have a different pain threshold. Therefore, the pain assessment is very delicate and needs to be based on many factors, scales to get accurate results. If the assessment and treatment of pain is not enough, it will lead to many bad consequences for the patient:
- Rapid pulse, increased blood pressure prone to bleeding, cardiovascular accidents
- Pain makes patients dare not move, cough and take deep breaths easily lead to respiratory failure, collapse of the lungs, pneumonia.
- Do not dare to exercise early, special postoperative physical therapy after osteoarthritis surgery will limit movement, stiffness, muscle atrophy, affect the results of surgery, increase the risk of embolism
- Insomnia, anxiety, depression
- The patient is uncomfortable, affecting the quality of life.
- Can lead to chronic pain.
- Immunosuppressively slows incision healing, slows recovery and increases the risk of post-surgery infection
- Prolonged hospitalization, increased risk of re-admission, increased cost of treatment
3. How to treat post-surgery pain to be able to effectively relieve pain?
First of all, it is necessary to properly assess the extent of pain more or less, depending on the condition of each patient to have an appropriate treatment plan. The main principle of post-surgical pain treatment: there is a coordination of the patient, the surgeon and the anesthesisiist.
- The patient must be involved in the treatment plan. Healthcare workers should listen to the patient's assessment of their pain symptoms.
- Surgeon: Apply laparoscopic surgery, small incision if possible to minimize tissue and neurological damage → pain relief after surgery for patients
- Anesthesisisisithesithesitics: understand and understand the characteristics of each patient, assess and treat pain properly according to the regimen, update and perform well the analgesic techniques, especially the anaesthetic technique under the ultrasound instructions.
- Early detection and planned pain treatment: Patients must be routinely monitored for post-surgery pain to be treated quickly after pain is detected. Note the risk factors when planning pain treatment: Types of pain-causing surgery (including abdominal chest surgery, surgery that greatly affects muscles, bones and nerve tissue, bone marrow transplantation), patient age, history of pain including chronic pain
- Use a multi-modal analgesic method: take as soon as possible, can start before surgery, combine regional or central analgesics with a variety of opioid and non-opiate painkillers to increase the effectiveness of treatment, minimize accidents and side effects when taking a lonely drug.
- Patient's pain profile and treatment route
- Evaluate and review the pain relief needs of patients 24 hours before being discharged to prescribe appropriate medications.
- Multi-modal analgesy regimen based on pain levels:
+ Level 1: Oral or oral medications, combination of non-opium analgesics (Paracetamol, Non-Steroidal Anti-Inflammatory, Nefopam) used in mild → mild pain
+ Level 2: Injectable or oral medications, combining non-opium-free analgesic drugs with opium (Tramadol, Nalbuphine, Morphine, Fentanyl …) used in → pain.
+ Level 3: Drugs by injection, orally, subcutaneously
Coordination of non-opium painkillers
Coordination of non-opium and opium painkillers
Regional anesthesia (pericardium, spinal anesthesia, peripheral nervous numbness, incision permeability) + opium (injection, oral, subcutaneous)
Regional anesthesia (pericardism, spinal anesthesia, peripheral neuropsychipsy, incision permeability) + opium + non-opium (injection, oral)
Regional anesthesia (pericardism, spinal anesthesia, peripheral nervous numbness, incision permeability) + non-opium (injection, oral)
Thus, post-surgery pain is not as scary as many people think if properly evaluated and treated. If the patient is equipped with knowledge of post-surgery pain, participating in the treatment process by coordinating well with the surgeon and anesthesihetizing pain will bring a good anesthetic effect.
At Share99 system, with modern equipment (pain index monitors, ultrasound machines specialized for regional anesthesia, nerve sysic machines …), specific treatment regimens, always update new techniques on regional anesthesia, provide patients with good postoscopic pain treatment services in accordance with the goal of "Pain Free Health Hub".
Share99 International Health Hub is one of the hospitals that not only ensures professional quality with a team of leading doctors, modern technology equipment system but also stands out for comprehensive and professional medical examination, consultation and treatment services; civilized, polite, safe and sterilized medical examination and treatment space.
Customers can directly go to Share99 Health System nationwide for examination or contact the hotline here for assistance.
- What is special about postoperative pain relief at Share99?
- The role of post-surgery pain relief
- Share99 and The Asian Anesthetics Council organized the first International Conference on Regional Anesthesia in Vietnam