Hospital Advocacy: Surgical Pain Management
Over the past 2 weeks, I have witnessed extraordinarily poor pain management for patients after major surgeries. Post-operative pain management is an important, but often undervalued, part of quality surgical care. How many of us ask about the surgeons’ pain management plan when we’re considering a surgical procedure?
We have known for many years that surgical pain is often underestimated and undertreated. Despite the fact that more attention has been paid to pain management in recent years, many patients continue to suffer with poorly managed surgical pain.
Recent reports estimate that 70% to 80% of surgical patients experience moderate, severe or extreme post-operative pain.
There are serious consequences when pain is poorly managed. In addition to the needless suffering of patients, the chances of respiratory and clotting complications are increased, as well as a longer hospital stay and development of chronic pain syndrome.
It’s important to know that it is your right to receive proper pain management after surgery. Hospitals have pain management standards to which they are held accountable. The standards require hospitals to:
- recognize the right of patients to appropriate assessment and management of pain
- screen patients for pain during their initial assessment and, when clinically required, during ongoing, periodic re-assessments
- educate patients suffering from pain and their families about pain management
What can patients do to improve their pain management after surgery?
- Before your surgery, have a discussion with your surgeon about pain control. Ask your doctor what to expect after the surgery and what is the surgical pain management plan.
- Ask about the different options and methods of post-operative pain management and their benefits and side effects.
- Tell your doctor about all pain medications that you are taking before surgery.
- Share with your doctor any problems that you may have had with pain control after prior surgeries.
- Ask how pain relief is monitored. By whom? How frequently? What is the plan if there is inadequate pain relief?
- Often problems with pain control occur when patients are transitioned from IV PCA (patient controlled analgesia) to oral pain medications after surgery. Ask about your doctor’s transition plan. Is it tailored to your pain needs or does your doctor follow a specific protocol? Good coverage needs to be carefully planned during this transition. All too often however, surgeons employ a “one size fits all” approach using the lowest dose of oral pain medications to start, which is arbitrarily used for all patients regardless of type of surgery, weight of the patient and previous pain medication use.
An individualized, evidence-based, post-operative pain management plan should be your surgeon’s routine practice. If you are not satisfied with your doctor’s responses to these questions, by all means get another opinion. Pain management is really that important!