What will I be given for pain after surgery
Glen Burnie, MD
There are a variety of medications available to control post-operative pain. I typically prescribe a patient-controlled anesthesia (PCA) machine for the first 1-2 days after surgery. This machine allows the patient to self-administer an intravenous pain medication, such as morphine, in a safe and effective manner. After a few days, the patient is transitioned to an oral narcotic medication. Another useful strategy is to place an epidural catheter in the operating room after the surgery is finished.
Dr. Thomas G. Lowe
Woodridge Orthopaedics & Spine Center, P.C.
This method has been called the growing rod or instrumentation without fusion. It has not turned out to be particularly effective as far as preserving growth. Merely putting in the instrumentation and adjusting it at six month to year intervals and often times resulted in fusion occurring with loss of growth potential. It is probably better most of the time to try to manage the curve with a brace. At approximately age 12 in girls and 14 in boys, the fusion with instrumentation can be performed without any significant loss of growth potential.
We typically will put patients on narcotic pain medication. This can range from morphine to Dilaudid. While the pain cannot be completely eliminated, it can certainly be controlled and you, the patient, can be made reasonably comfortable after surgery. After a few days, oral pain medication is given to allow you to go home on the same medicine that controls the pain in the hospital.
New York, NY
For the first two or three days after surgery you will be given PCA, which is an abbreviation for "patient controlled analgesia". Essentially this is a pump containing morphine that is delivered through an intravenous line in the arm when a button is pushed by the patient. The patient has control over pain medication without having to wait for a nurse to administer the drug. After 2-3 days when the pain subsides and the patient is able to tolerate medication by mouth, a milder oral narcotic is administered.
Los Angeles, CA
I give my patients, both children and adults alike, a patient-controlled analgesia for 24 to 48 hours after surgery. By pressing a button, the patients can administer incremental doses of narcotic medication to control their pain. After that time period, pain injections and oral pain pills are given, which is usually sufficient. Patients are discharged on oral narcotic pain pills, which they may need to take for a few weeks after surgery.
Patients are typically given a pain reliever, such as Tylenol® with codeine, several weeks following surgery. Narcotic treatment is usually stopped two weeks after surgery.
St. Louis, MO
Immediately after surgery, pain is managed with a PCA (patient-controlled analgesia). By pushing a button, you can administer your own intravenous pain medication without the need of the nursing staff. As intake of fluids and food improves after surgery, oral pain medications will be started and the PCA will be gradually weaned off in preparation for hospital discharge. No injections are used for pain medication in our hospitals after surgery.
Currently, there are numerous techniques for effective pain management after spinal surgery. These include injections through intravenous catheters, oral medication, patient controlled analgesic delivery systems and epidural catheters placed during surgery to deliver either narcotics or local anesthetics directly to the spinal nerves to prevent pain. Generally, patients are on a combination of these treatments for 2-4 days after surgery after which oral analgesics are typically sufficient. Pain medication will be administered for up to three months after surgery in decreasing doses to control residual pain.
New York, NY
After surgery your pain will be controlled through the collaborative effort of the surgeon, anesthesiologist, and the pain service. Often for the first twenty-four hours post-operatively, the patient will be given IV narcotics such as morphine through a PCA (patient controlled analgesia) pump. This allows a certain amount of medicine to be distributed at set timings through an IV. There is also a button the patient can press for an additional dose of pain medicine if necessary. The machine is computerized and the patient cannot exceed a programmed amount of medication per hour. After the PCA is discontinued the patient will convert to pain medication by mouth, in preparation for discharge home.
Pain control is tailored to each patient. My preference is to use an epidural catheter for the first 1-2 days after surgery and then transition to oral narcotic medicines. By 2-3 weeks, most patients are able to control their discomfort with over-the-counter acetaminophen or ibuprofen.
University of Utah Department of Orthopaedic Surgery
Scoliosis correction is a very major intervention. Our practice is to use either patient controlled analgesia, (PCA), in which patients administer their own narcotics at a rate controlled to prevent over-sedation, or through the placement of a catheter into the spine at the time of surgery. Such "epidural catheters" allow patients to mobilize faster from bed, give equal or better pain control, and have fewer side effects than peripheral narcotics. This is generally our preference for adolescent idiopathic scoliosis correction.
Pain after surgery is usually managed with some type of intravenous pain medication. The appropriate medication will be determined for you by your surgeon in conjunction anesthesia or pain management service.
Each place has it's own treatment regimen for pain. Typically you will be given a machine called a PCA (patient controlled analgesia) which allows you to control when you get your pain medicine through your IV. It is setup so that you can't give yourself too much medicine. As soon as your tummy is working (by making gurgling sounds and passing gas from your bottom), then you will be given pain medicine, such as codeine, by mouth. Usually in a couple of more days acetaminophen is enough. The other things we sometime use for pain medicine include epidural catheters (like a woman in labor might have) or special shots before surgery called intrathecal (into the spinal sac) medicines.
We tell patients that there is no way to have spinal surgery without pain, but patients should never be miserable. Pain medication can be given continuously through an IV. Additional medication can be given by patients pushing a button attached to the IV. If pain still persists, yet more medication is available from the nurse. Pain levels should be frequently assessed by the nursing staff and treated appropriately.
Texas Scottish Rite Hospital Orthopedic Group
Pain medication such as morphine is given intraoperatively as well as postoperatively to minimize pain.
New York, NY
The commentary above recounts the experiences of these physicians. Medtronic invited them to share their stories candidly. Keep in mind that results vary; not every patient's response is the same. Talk with your doctor to learn more about any products that are mentioned above.
It is important that you discuss the potential risks, complications and benefits of spinal surgery with your doctor prior to receiving treatment, and that you rely on your doctor's judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.