Will I have pain after my operation?
Yes, unfortunately limb reconstruction surgery is accompanied by pain post-operatively, but there are many available methods of pain relief which you can discuss with your anaesthetist and the pain team.
How can the pain be relieved immediately after my operation?
Post-operative pain relief is tailored to individual patient needs. This can be a combination of different methods that include a PCA, local anaesthetic infiltration or regular opiate-based analgesia orally.
Are there any alternatives to morphine?
Yes, there are other equally strong pain killers such as oxycodone or fentanyl. There are given either into a vein (intravenous) or under the skin (subcutaneous).
Are there any dangers associated with morphine?
Morphine can cause you to become drowsy and your breathing to slow down and become more shallow if you have too much of it. The nurse will check this at regular intervals.
Can I overdose myself with a PCA?
No. If you are using a PCA machine and you become drowsy you will not press the button on the machine. The machine is set to deliver small doses at 10 minute intervals, so you will not overdose yourself. This is called the ‘lock-out’ period. It is most important that you and only you press the button to activate the PCA.
Can I become addicted to morphine?
You should use morphine for as short a time as possible. You will not become addicted to it in a few days. If you need it for longer than 2 weeks you can become tolerant (need more and more to have the same effects) or dependent (withdrawal symptoms such as shivering, shaking and nausea when it is stopped). The pain team nurses and doctors will come and advise you about other pain relieving drugs if your pain is persistent.
Will my pain last for a long time?
This is very variable but, because of the pins and frame, there tends to be pain and discomfort for several weeks.
What can be done to help persistent pain and discomfort?
Less strong pain relieving drugs are used, such as codeine and Tramadol. If these are not strong enough for you a slow acting morphine table taken twice a day by mouth can be used, or a drug called buprenorphine can be given as a skin patch. Paracetamol is safe and this is continued for as long as you need it.
Other drugs, such as Gabapentin and Amitriptyline, are often used for nerve pain.
Can anti-inflammatory drugs such as Ibuprofen (Brufen, Nurofen) and Diclofenac (Voltarol) be used?
No. This group of pain killers is not recommended as there is evidence as they can delay bone healing.
What are the side effects of painkillers?
- Nausea, occasionally vomiting (being sick)
- Constipation (you may need laxatives)
- Itching all over the body (without a rash)
- Difficulty in passing urine (especially if you have a prostrate problem)
- Mood changes
- Headache (Tramadol)
These side effects may pass or you may need to try a different pain killer.