Home > Lifestyle > Health
Wednesday October 9, 2013 MYT 12:00:00 AM
Wednesday October 9, 2013 MYT 5:08:30 AM
by datin dr v. sivasakthi AND dr mary suma cardosa
Subletting pain-free postion: While many cases of post-operative analgesia are managed by surgeons, anaesthesiologists and an acute pain service team (if available) will provide pain relief for most major surgeries and day-care surgeries.
This third article in conjunction with National Anaesthesia Day on Oct 12 explores dealing with pain after surgery.
PAIN after surgery is common, and it varies depending on the extent of surgery. But, with modern medicines and techniques, you do not have to suffer the pain after surgery any more.
The main aim of giving good pain relief after surgery is to alleviate suffering. In addition, good pain relief also minimises adverse effects on the heart and lungs, and maximises comfort.
Early recovery is enhanced by one being able to sit up, breathe deeply and ambulate early soon after operation.
There are multiple pain relieving methods that range from pills (oral analgesic medications) and analgesic injections to regional anaesthesia techniques (spinal, epidural and peripheral nerve blocks).
The method of pain relief you will be given depends on the type of surgery, part of body affected and whether you are allowed to eat or drink soon after surgery.
Acute Pain Service (APS)
Postoperative analgesia is a shared responsibility between surgeons and anaesthesiologists. While many cases are treated by surgeons, anaesthesiologists and an acute pain service team (if available) will provide pain relief for most major surgeries and day-care surgeries.
In government hospitals, a total of 91,766 patients received postoperative pain management under the Acute Pain Service in 2012.
Patients will be monitored by trained nurses who will assist the anaesthesiologists in caring for these patients.
Two of the methods commonly used by the APS are Patient Controlled Analgesia (PCA) and epidural analgesia.
PCA is a method where a pain-relieving drug is delivered into your body by pressing a demand button. This technique allows you to titrate analgesic medications according to your requirements.
It is a very safe and effective method of pain relief after surgery because there are certain limits set by the machine which delivers the analgesic medication, and usually patient satisfaction is very high as they do not have to wait for the nurse to give them the medication when they need it.
Epidural analgesia is a technique where a mixture of local anaesthetic and a morphine-like medication is given through a small plastic tube (catheter) which is inserted into the epidural space (a space in the spine). It is another very effective technique of post-operative analgesia where we can give an infusion of local anaesthetic for 24-48 hours in cases like knee replacement surgery.
Modern techniques of analgesia usually combine different drugs and techniques to maximise benefits and minimise side effects of the medications used, termed Multimodal Analgesia. Side effects are inevitable, but these are all treatable.
To achieve the best results, patients can participate in their recovery by informing the nurses if they are still in pain or suffering from side effects like nausea or vomiting, giddiness or numbness of the legs, so that this can be addressed immediately to optimise your comfort. Patient comfort is our priority.
Do’s and don’ts
Do not stop taking the analgesic medication despite side effects. Rather, these should be treated by conveying your problems to the APS team, who will then give appropriate medications.
It is important that even after major surgery, you should try to mobilise as soon as possible. You should be comfortable enough to move with the existing analgesics. It really is your right to have good pain relief after surgery, and you should not be afraid to ask for it.
Pain plays a protective role in most situations – it reminds us to prevent further damage to injured tissues. This goes to surgical wounds as well – once the wound starts to heal, the pain reduces, and once healing is complete, the pain usually goes away completely.
However, in a small percentage of people, pain can persist even after healing – this is called chronic post-surgical pain (CPSP). We do not fully understand the reasons why this occurs. Research has shown that poor postoperative pain control puts you at risk of developing CPSP. This emphasises the need for good postoperative pain control.
Pain will be managed differently if you developed CPSP. Inform your surgeon about this, and he will refer you to a pain clinic, where you will be managed by a multidisciplinary team of doctors and allied health professionals using a multi-modal approach, which includes medication, exercise, relaxation and other self-management techniques.
The management of chronic pain is more challenging, but it is definitely possible to learn to empower oneself to manage pain so that one does not have to suffer and can return to a normal life despite persistent pain.
Pain clinics are now available in most tertiary referral centres and some private hospitals.
National Anaesthesia Day
Interested to learn more about anaesthesia? We invite you to unveil an anaesthesiologist’s mask during this National Anaesthesia Day celebration.
This year, “Your LIFE... We CARE!!!” has been chosen as the main theme for the celebrations, and it refers to our commitment to ensure that your life is in safe hands under our care.
> Datin Dr V. Sivasakthi and Dr Mary Suma Cardosa is head of Anaesthesiology and Intensive Care Services, Malaysia, as well as head of the Department of Anaesthesiology and Intensive Care, Hospital Kuala Lumpur. Dr Mary Suma Cardosa is with the Department of Anaesthesiology and Intensive Care, Hospital Selayang. Oct 16 was observed as World Anaesthesia Day in 1996, 150 years after the specialty was founded, and it is now celebrated annually worldwide. The Malaysian Society of Anaesthesiologists and the Department of Anaesthesiology & Intensive Care, Hospital Kuala Lumpur, is launching National Anaesthesia Day to increase awareness about the role of anaesthesiologists and how they contribute towards patient care.
Listed below is a snapshot of our
Oct 12, 2013 – Taman Tasik Titiwangsa
1. Walk Treasure Hunt – Registration form can be downloaded from www.msa.net.my.
2. Save a life today by learning about basic life support with hands-on cardiopulmonary resuscitation (CPR) session.
3. Video shows and exhibitions.
4. Free medical check-up.
5. Blood donation drive and organ donation pledge.
Hospital Kuala Lumpur events
1. Exhibitions at the main foyer of Hospital Kuala Lumpur (Oct 21-25, 2013)
2. Health talks on Oct 25, 2013 – Main Auditorium, Hospital Kuala Lumpur
Tags / Keywords:
Health, anaesthesia, pain control, post-surgery
Copyright © 1995-2013 Star Publications (M) Bhd (Co No 10894-D)