1. What is pain
Pain is an unpleasant feeling and emotional experience caused by tissue damage or potential tissue damage
Postoperative pain: acute pain immediately after surgery
Clinically, it is mainly divided into two categories: acute pain (less than 1 month) and chronic pain (more than 3 months)
The key causes of chronic pain: poor postoperative pain control and mental depression
2. The harm of postoperative pain
Postoperative pain is a reaction of the body after trauma, infection, surgery and other stimuli, including psychological and physiological changes in behavior.
Can affect mood, produce anxiety, depression, depression, fear
Why does anorectal surgery become more painful
The mucosa of the anal canal is rich in nerve endings and is very sensitive to touch, pain, temperature, and squeeze caused by bowel movements
After the operation, the wound was exposed, the nerves were stimulated, and the anal muscles contracted involuntarily.
Postoperative wound edema or infection, improper packing of postoperative anal canal
Stool directly irritates the wound during defecation
Some patients are anxious due to poor pain control, aggravated nervousness, fear of defecation and dressing changes, and fall into a vicious circle
Should the pain be endured as much as possible?
These concepts are out of date!
"Pain after surgery is normal"
"Just endure the pain"
"It hurts all the time, isn't it?"
"Wait until the pain is over, call the doctor again!"
Misunderstandings about postoperative pain
Misunderstanding 1: surgical pain is normal and inevitable
Doubt: Pain can cause some physical and mental diseases, such as gastrointestinal dysfunction, cardiopulmonary dysfunction, blood clotting state leading to thrombosis, etc. Pain can also lead to psychological problems.
Such as: insomnia, dreaminess, irritability and anxiety. It can be said that the side effects of taking analgesics are much less harmful to the body than pain, so you don't need to bear the pain.
Misunderstanding 2: Too many painkillers can be addictive and affect intelligence
Solution: Analgesics are simply used for postoperative analgesia, with a short course of treatment and small doses. If the medication is used on time, the concentration of the drug in the blood is relatively stable and will not change drastically. Addiction is related to the fluctuation of drug concentration in the blood, so the regular use of medication for postoperative pain relief will not lead to addiction dependence. The analgesic drugs currently used in the clinic are highly safe, and for adults with well-developed brains, these drugs have no effect on intelligence
Misunderstanding 3: Take painkillers only when you are in pain, not take it temporarily
Undoubted: Timely administration is a basic principle of analgesia, which can maintain a stable blood drug concentration, which can effectively reduce drug resistance and drug addiction. Special attention should be paid to the fact that the patient received multi-modal analgesia during hospitalization, and the pain effect was well controlled. However, after discharge, it is considered that there is no pain during the hospitalization period, and it will be less painful after discharge. Following the doctor's advice and taking the medicine on time throughout the course will get twice the result with half the effort
How to perform a pain assessment
Pain is a very competent feeling. The intensity of pain mainly depends on the description of the patient. There are also some simple and professional methods to assess the intensity of pain.
When you feel slight pain, you should assist the medical staff to assess the intensity of the pain (location, time and frequency, intensity of pain)
Not only report the intensity of pain at rest, but also report the intensity of pain during activity, coughing, and deep breathing.
And the impact of pain on sleep, and began to intervene in analgesic programs.
What is perioperative analgesia?
Postoperative pain is currently the most common clinical pain, but modern advanced analgesic concepts do not only emphasize postoperative analgesia.
More emphasis is placed on perioperative analgesia, including continuous, multi-modal analgesia before, during, and after surgery.
Advocate for timely analgesia during the perioperative period to ensure the analgesic effect
What is multimodal analgesia?
The current multimodal analgesia advocated during the perioperative period refers to the so-called application of two or more analgesic drugs or methods with different mechanisms of action, acting on different levels of pain receptors or conduction.
Reduce single-drug dosage and avoid adverse reactions caused by single-drug overdose. At the same time, it improves the tolerance of the drug, accelerates the onset time and prolongs the analgesia time.
The most common side effects of opioids (including morphine, fentanyl, codeine, etc.) include nausea, vomiting, constipation, lethargy and excessive sedation),
Clinically, opioids are used in combination with other analgesics, multi-modal analgesia, reducing their dosage, thereby reducing side effects.
Advantages of perioperative analgesia
Reduce postoperative pain and improve quality of life
Relieve tension and reduce cardiovascular system complications
Let you dare to breathe and cough deeply, reduce atelectasis and lung infections
Allows you to get out of bed early, reduce the problems of venous thrombosis and pulmonary embolism in lower limbs that may be caused by long-term bed rest, and promote the recovery of gastrointestinal function
Improve sleep, make you more energetic during the day, and better cooperate with treatment
Allows you to fully perform rehabilitation exercises to achieve the best therapeutic effect
Current pain treatment
1. Non-drug treatment
Including psychological counseling, distraction, relaxation therapy, massage, acupuncture, etc.
2. Drug therapy
Including selective COX-2 inhibitors, non-steroidal selective non-body drugs and opioid analgesics
I have used an analgesic pump, do I need to use other analgesics?
The analgesic pump mainly uses opioids, which have strong analgesic effects, but have limited effects on sports pain.
And has certain side effects (nausea, vomiting, lethargy, respiratory depression, etc.)
Cooperating with other analgesics can reduce the amount and side effects of opioids and enhance the analgesic effect.
How to cooperate with medical staff to achieve the best pain relief effect
Express the desire to understand pain and pain management with medical staff
Communicate with medical staff to understand the analgesic treatment plan and eliminate concerns about analgesic drugs
Actively cooperate with medical staff to implement pain relief programs
When pain occurs or cannot be relieved, report to the medical staff in time
At present, we carry out comprehensive analgesia during the perioperative period, and the patients are basically painless after the operation.
(Picture from the Internet)