Types of pain medication
Post-surgical pain is usually managed with multiple pain-reducing medications (analgesics). The appropriate type, delivery and dose of medications for you depend on the type of surgery and expected recovery, as well as your own needs.
Pain medications include the following:
- Opioids, powerful pain medications that diminish the perception of pain, may be given after surgery. Intravenous opioids may include fentanyl, hydromorphone, morphine, oxycodone, oxymorphone and tramadol. Examples of opioids prescribed in pill form after surgery include oxycodone (OxyContin, Roxicodone, others) and oxycodone with acetaminophen (Percocet, Roxicet, others).
- Local anesthetics, such as lidocaine and bupivacaine, cause a short-term loss of sensation at a particular area of the body.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) — such as ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, Anaprox, others), celecoxib (Celebrex) or ketorolac — lessen the inflammatory activity that worsens pain.
- Other nonopioid pain relievers include acetaminophen (Tylenol, others) and ketamine (Ketalar).
- Other psychoactive drugs that may be used for treating post-surgical pain include the anti-anxiety medication midazolam or the anticonvulsants gabapentin (Gralise, Horizant, Neurontin) and pregabalin (Lyrica).
While opioids may or may not be appropriate to use after your surgery, your surgeon will likely prescribe a combination of treatments to control pain, lessen side effects, enable you to resume activity appropriate for recovery and lower risks associated with opioids.
Managing the risks of opioid use
Opioids are often critical for post-surgical pain management because of their powerful effect. But their side effects can be significant, including nausea, vomiting, constipation, urinary retention, drowsiness, impaired thinking skills and poor respiratory function.
Overdosing and misuse of opioids also are risks, particularly when opioids are used to treat ongoing (chronic) pain. Although the use of opioids after surgery is intended as a short-term strategy to relieve pain while the body heals, the risk of misuse is still a concern.
Because of the risks associated with opioids and their potential side effects, these drugs should be used carefully, if at all. Opioids should be used at the smallest dose effective for the shortest possible time.
You and your doctor should discuss steps you can take to reduce the risks associated with opioid use, including:
- Taking medication only as directed, minimizing dose and length of opioid use
- Talking to your doctor when your pain is not under control
- Not using alcohol while taking opioids
- Following your doctor’s instructions about other drugs not to take while using opioids
- Storing drugs safely
- Disposing of unused drugs, ideally through a pharmacy take-back program
- Not sharing your medication with other people