How long does pain last after skin surgery. Stitches hurt after surgery: causes and how to get rid of pain

05.04.2020 -

The prospect of surgical intervention frightens many: operations are associated with a risk to life, and even worse - to feel helpless, lose control of your own body, trusting doctors for the duration of anesthesia. Meanwhile, the work of the surgeon is only the beginning of the path, because the result of the treatment half depends on the organization of the recovery period. Doctors note that the key to success is in the right attitude of the patient himself, who is ready to work on himself in close cooperation with specialists.

Features of postoperative rehabilitation

Rehabilitation therapy has many goals. These include:

prevention of possible complications of the operation;
relief of pain or restrictions in mobility;
acceleration of recovery and psychological recovery after the disease;
the return of the patient to an active healthy life.

At first glance, nothing complicated - it may seem that the human body itself is able to recover from a serious illness or traumatic surgical intervention. Many patients naively believe that the most important thing in the postoperative period is healthy sleep and good nutrition, and the rest will “heal by itself”. But it's not. Moreover, self-treatment and carelessness in relation to rehabilitation measures sometimes nullify the efforts of physicians, even if the initial outcome of treatment was assessed as favorable.

The fact is that the recovery of patients after operations is a full-fledged system of medical measures, the development of which is carried out by a whole science, rehabilitation. The civilized world has long abandoned the idea of providing patients with complete rest for a long time after surgery, because such tactics aggravate the patient's condition. In addition, with the introduction of minimally invasive operations into medical practice, the focus of rehabilitation has shifted from healing the skin in the area of the scar to restoring the full functioning of the body already on the second or third day after the intervention.

It is not necessary to get hung up on thoughts about the intervention itself during the preparation for the operation, this will lead to unnecessary worries and fears. Rehabilitologists advise you to think in advance what you will do when you regain consciousness on the first day after the operation. It is useful to take a player, a book or a tablet computer with your favorite movie with you to the hospital, which will help you escape from unpleasant sensations and tune in a positive way.

The competent organization of the recovery period after surgery is especially important for elderly patients who are more difficult to tolerate surgical interventions. In their case, the feeling of helplessness and forced restriction of mobility often develops into severe depression. People aged sometimes endure pain and discomfort to the last, embarrassed to complain to the medical staff. A negative psychological attitude interferes with recovery and leads to the fact that after the operation the patient will never fully recover. Therefore, the task of relatives is to think in advance about how the rehabilitation period will go, to choose a suitable clinic and a doctor responsible for the quick recovery and well-being of an elderly person.

Recovery period after surgery

The length of recovery after surgery depends on many factors. The most significant of these is the nature of the operation. So, even a person with good health after a small intervention on the spine will need at least 3-4 months to return to a full life. And in the case of extensive abdominal surgery, the patient will have to follow a strict diet for several years to prevent the formation of adhesions. Separate conversation - operations on the joints, which often require numerous sessions of physiotherapy and therapeutic exercises, aimed at restoring lost functions and mobility of the limb. Well, after emergency interventions for a stroke or heart attack, the patient sometimes has to recover for many years in order to regain the ability to be independent and work.

The complexity of the operation is far from the only criterion for the duration of rehabilitation. Doctors pay special attention to the age and gender of the patient (women tend to recover faster than men), the presence of concomitant diseases, bad habits, and the level of physical fitness before surgery. The motivation of a person to recover is also important - therefore, psychologists work in good rehabilitation centers along with doctors.

Methods for restoring the body after surgery

Restorative therapy has an impressive number of methods in its arsenal, each with its own strengths and weaknesses. Most patients in the postoperative period are advised to use a combination of several appointments, along the way fixing what exactly brings the greatest health benefits in each case.

Medications . Pharmacological support is an important aspect of comfortable recovery after surgery. Patients are prescribed painkillers, as well as vitamins and adaptogens - substances that increase vitality (ginseng, eleutherococcus, pantocrine and other drugs). After some types of interventions, special drugs are prescribed: during neurological operations, patients are often shown botox therapy - injections of botulinum toxin, which relieve muscle spasms, reducing tension in various parts of the patient's body.
Physiotherapy implies the beneficial effect of physical factors (heat, water, electric current, etc.) on the human body. It is recognized as one of the safest methods of treatment in modern medicine, but it requires a competent approach and careful recording of the result. Experienced specialists in laser therapy, electromyostimulation and diadynamic therapy are in high demand today, because they help speed up wound healing, relieve inflammation and reduce pain after any type of surgery.
Reflexology . This method of rehabilitation involves the impact on biologically active points on the human body with the help of special needles or "cigars" (moxa). It is classified as alternative medicine, but the effectiveness of reflexology has been repeatedly confirmed in the practice of many rehabilitation centers.
exercise therapy (physiotherapy exercises) useful both for people who have undergone surgery on the bones and joints, and for patients recovering from cardiac surgery or stroke. The built-in system of regular exercises helps not only at the physical level, but also psychologically: the joy of movement returns to the person, mood improves, appetite increases.
Mechanotherapy , despite the similarity with exercise therapy, refers to an independent method of rehabilitation of patients after surgery. It involves the use of simulators and special orthoses that facilitate the movement of debilitated patients and people with disabilities. In medicine, this method is gaining more and more popularity due to the introduction of new, improved devices and devices into practice.
Bobath therapy - a technique aimed at eliminating spasticity (stiffness) in the muscles. It is often prescribed to children with cerebral palsy, as well as to adults who have suffered an acute cerebrovascular accident. The basis of Bobath therapy is the activation of movements by stimulating the patient's natural reflexes. In this case, the instructor with his fingers acts on certain points on the body of his ward, which tones up the work of the nervous system during classes.
Massage prescribed after many surgeries. It is extremely useful for older people suffering from diseases of the respiratory system, who spend a lot of time in a horizontal position. Massage sessions improve blood circulation, increase immunity and can be a transitional stage that prepares the patient for active rehabilitation methods.
diet therapy not only allows you to make the right diet in the postoperative period, but also plays a role in the formation of healthy habits in the patient. This method of rehabilitation is especially important in the recovery of patients after bariatric operations (surgical treatment of obesity), people suffering from metabolic disorders, and debilitated patients. Modern rehabilitation centers always make sure that the menu for each patient is compiled taking into account his individual characteristics.
Psychotherapy . As you know, the development of many diseases is influenced by the thoughts and mood of the patient. And even high-quality medical care will not be able to prevent the recurrence of the disease if a person has a psychological predisposition to feeling unwell. The task of the psychologist is to help the patient realize what his illness was connected with, and tune in to recovery. Unlike relatives, a psychotherapist will be able to make an objective assessment of the situation and apply modern methods of treatment, if necessary, prescribe antidepressants and monitor the person's condition after the end of rehabilitation.
Ergotherapy . The most painful consequence of serious diseases is the loss of the ability to self-care. Ergotherapy is a complex of rehabilitation measures aimed at adapting the patient to normal life. Specialists working in this field know how to restore self-care skills to patients. After all, it is important for each of us to feel independence from others, while close people do not always know how to properly prepare a person after an operation for independent actions, often overprotect him, which prevents proper rehabilitation.

Rehabilitation is a complex process, but you should not consider it an impossible task in advance. Experts recognize that the main attention should be paid to the first month of the postoperative period - the timely start of actions to restore the patient will help him develop the habit of working on himself, and visible progress will be the best incentive for a speedy recovery!

After various kinds of surgery, patients experience pain (permanent or periodic), requiring safe anesthesia. The reasons for the occurrence of pain can be both increased sensitivity of the damaged area of soft tissues, and their swelling.

Relieve severe pain after surgery with pills containing narcotic substances. Since these drugs can cause negative reactions or addiction in the body, they should be used only as directed and under the supervision of a physician.

Self-administration of potent analgesics leads to side effects (increased sedation, nausea). Only the attending physician prescribes the necessary drug, taking into account the characteristics of the patient's body and the nature of the surgical procedures.

Effective pain relievers

Pills after surgery help to alleviate the patient's condition, relieve pain, prevent the development of the inflammatory process and restore his vital potential, of which the most common painkillers with anti-inflammatory effects are:

Paracetamol is an analgesic with an accelerated action and a low probability of developing negative effects when used. Depending on the degree of pain, combinations of drugs are prescribed - Solpadein, Sedalgin-Neo, Pentalgin. Of the safe drugs that do not contain narcotic substances, they are used (for moderate pain): Ibuprofen, Citramon and Analgin.

Tramadol is an analgesic (opioid) synthetic, of medium strength, which only in rare cases causes physical and mental dependence, and also does not adversely affect intestinal motility and respiratory function, does not depress the patient's blood circulation and psyche.

Zaldiar is a drug created by combining tramadol with paracetamol, which has an enhanced and prolonged analgesic effect. If the necessary pain relief does not occur, then an additional intake of other analgesics is prescribed (for example, Diclofenac, Promedol).

Potent analgesics include pills after surgery - Ketorol, Nise, Nurofen. Ketorol is recognized as the most effective, as well as its derivatives (Toradol, Dolac, Ketorolac, Ketanov). Ketorol, having an antipyretic effect, is not intended for the treatment of inflammatory diseases, but only for pain relief.

In maxillofacial surgery, in addition to the listed drugs, Ketonal, Migrenol, Trigan-D, Deksalgin 25, Next are also used. If necessary, the doctor after the operation prescribes anti-inflammatory drugs (Mefenamic acid, Nimesil), and, for example, after a complex extraction of teeth, strong antibiotics - Sumamed, Amoxiclav, Ceftriaxone, together with desensitizing tablets (Suprastin, Coaritin, Tavegil, Loratadin, Erius).

Before the tooth extraction operation, you should inform the attending physician about what drugs you are currently taking (anticoagulants, insulin, oral contraceptives) in order to make it easier for him to choose the necessary anesthetic, as well as to choose the right medicines for postoperative care.

After surgery, for example, to remove a parathyroid tumor, it is recommended to take vitamin D and calcium tablets, which strengthen bone tissue.

Doctors do not recommend to abuse the use of potent drugs, but to use them only if necessary, since it is possible to cause the opposite result (increased pain) by constantly taking them. You should carefully study the contraindications for use, weighing all the pros and cons.

What painkillers are prescribed after surgery

What painkillers after surgery can be prescribed? This question worries many people, because no one is immune from surgery. The human body has long been subject to the negative influence of microorganisms: bacteria and viruses that destroy human health. Pests of the body live due to the fact that they infect human tissues and organs and, therefore, cause significant harm to human health.

In our time, medicine is developing so rapidly and rapidly that harmful microorganisms do not have time to adapt to various antibiotics, medicines and drugs. So, one of the most miraculous ways is an operation, during which one or another type of disease is eliminated. However, some people experience severe pain as they gradually recover from anesthesia. How, then, at least for a while, to extinguish severe pain, if it brings a person even to tears?

A variety of drugs today

Any medical substances (for example, painkillers, pills or antibiotics) can help the human body to achieve full health. The question, most likely, is not in the types of existing drugs, but in the correctness of their use. So, with the wrong use of any medical medicine, there are very diverse negative consequences.

According to numerous social observations, the most common way of suicide is drug overdose.

Medicine is developing rapidly, making new discoveries almost every day. To date, pain pills after surgery are not something new and unattainable. So, if the patient experiences acute discomfort after the operation, a variety of medications come to the rescue.

If the operation relieves the human body of the disease, then why does the person experience acute malaise?

An operation is a medical effect on the human body, the purpose of which is to eliminate a developing disease in the human body. Of course, the operation is carried out exclusively with the participation of doctors who have received a license in a particular field. However, the question arises: if the operation relieves the body of the disease, why does the person feel unwell after? The answer to it is the structural features of the human body. The fact is that human tissues are a collection of similar cells that perform the same functions. Almost every tissue of the human body is affected by third-party objects, which leads to its modifications. For example, when cut with a knife, tissue is destroyed, after which bleeding begins. A similar effect occurs during surgery: the tissues of the human body are amenable to surgical intervention, after which they experience the process of "rehabilitation".

Speaking as simply as possible, the doctor destroyed the tissue (made an incision) and restored it (sewn up the wound). The human body feels pain after the action done, as the tissue, restoring its structure, excites the nervous system. It is known that the nervous system is the "foundation" of the human body. When nerve endings are stimulated, the human body receives signals in the form of pain sensations.

Drugs, antibiotics and pills that can help a person with pain

The pain experienced after surgery is very often so severe that a person cannot even move, as this brings him catastrophic discomfort. However, modern medicine is able to offer a variety of painkillers, drugs and antibiotics after surgery that can extinguish any, even the most severe, pain that has arisen in the human body.

The traditional approach in treating a patient after surgery is to "combine" a variety of drugs. Naturally, in order to avoid various injuries, you should not take them on your own. The attending physician should give you recommendations, after which you can proceed directly to the treatment itself. However, more often than not, doctors prefer to treat their patients on their own.

The "combination" method consists in the use of a variety of drugs, the purpose of which is the general repayment of pain after surgery. However, each medicine is unique in its own way and acts on the human body depending on the specified composition. By building a “scheme” for taking medications, the doctor starts the process of pain relief in your body.

To date, painkillers are one of the best friends of the human body. Unique in their structure and action, these drugs are able to save the human body from severe pain.

Types of painkillers after surgery

One of the most popular means of pain relief for terrible pain after surgery is the famous paracetamol.

Penetrating into the fire, paracetamol tablets activate the vital processes of the human body, which contributes to the speedy recovery of the affected area of the body.

Painkillers are sold in almost every modern pharmacy and have a relatively low price.

Anesthesia of the body after surgery often takes place with the participation of Ketone tablets. This type of medicine is not used for chronic diseases and has a number of limitations. For example, the drug should not be taken: children under the age of 16, pregnant women, breastfeeding, asthma, diathesis, ulcers, and so on. So, under the influence of this drug, anesthesia occurs not only after surgery, but also, for example, with osteochondrosis, menstruation, fractures, tissue structure disorders, oncology, abdominal pain, and even after the removal of a diseased tooth.

It is important to have a drug such as aspirin. This drug helps to cope with pain in different parts of the human body, as well as at high temperatures. However, like all drugs, aspirin has a number of limitations. For example, the use of the drug is contraindicated in inflammation of the gastrointestinal tract, pain during menstruation and children, including adolescence. Thus, the use of aspirin can cause the development of liver disease in adolescents and even affect the human brain. By the way, aspirin is quite cheap.

One of the controversial painkillers of modern medicine is analgin, which affects the human body. For example, it is much more effective than paracetamol. However, this drug adversely affects the circulatory system, liver, kidneys and lymphatic system. Modern doctors are of the opinion that this device should be used only in case of critical need. For example, when other painkillers did not have the desired effect.

Medicines that have a positive effect after surgery are injections. Usually, the attending physician independently prescribes the necessary dosage of the drug, which is subsequently used by the nurse.

It is possible to draw conclusions

Pain relief after surgery is one of the most popular topics of modern medicine. Almost every day, modern doctors are trying to discover new tools that can have a better effect on the human body. If you experience pain after surgery, you should contact your doctor.

However, you should not use painkillers for long-term pain, as you may not notice the development of any ailment. In this case, you must go to the hospital and be examined by your doctor. Remember that you should not engage in "self-treatment", as this will not lead to anything good.

Pain injections after surgery

Painkillers for injections after surgery. Names and applications

The use of analgesics of various groups during the period of postoperative rehabilitation is due to the elimination of pain, improvement of the patient's quality of life, reduction of complications and length of stay in a medical institution.

Pain relief after surgery helps the body recover faster

What pain relievers are available after surgery? Types and features of drugs

In hospitals and clinics there is a formulary system for the use of medicines of various groups. Their application depends on the characteristics and needs in each case. The need for use must be confirmed by medical research.

Painkillers after surgery. Pain relievers

Drugs intended for postoperative analgesia are presented in the table.

Strong narcotic analgesics

In turn, narcotic drugs are divided into:

synthetic;
semi-synthetic;
based on natural ingredients.

The drugs in this group have a pronounced analgesic effect. It is this property that is most important in the postoperative state.

Pain injections after surgery, namely the use of opiates, are justified during the first 3 days after complex operations. Further use may adversely affect the human psyche. This is due to the fact that drugs cause a psychotropic effect for a while, as a result of which drug addiction may develop.

Side effects of these injections may include:

vomit;
nausea;
increased intestinal tone;
disturbances in the work of the heart.

The occurrence of such unpleasant consequences can be avoided by proper dosage and short-term use.

Attention! The use of opioid analgesic injections after surgery is allowed only in accordance with certain standards and in cases established by the relevant law of the Russian Federation in the field of healthcare.

Drugs that do not contain drugs, pain relief is weaker. Their advantage is the relief of heat and inflammation in the body. It is this ability that makes them indispensable when used after surgery.

Improper use of such drugs can lead to a deterioration in the patient's condition.

Injectable painkillers used after surgery

Ketonal

Ketonal is often used to eliminate postoperative pain syndrome. It simultaneously removes pain, reduces temperature and works as an anti-inflammatory agent.

Pain most often appears and intensifies precisely because of inflammation of various etiologies.

The process of stopping the focus occurs due to the blocking of certain enzymes. They contribute to the appearance of the inflammatory process in the body.

Regarding the antipyretic ability, there is an assumption that the synthesis of prostaglandins, which causes an increase in temperature, is disturbed due to the influence of the active substance of Ketonal - ketoprofen.

The drug belongs to the group of non-steroidal anti-inflammatory drugs, the use of which has its positive and negative sides.

postoperative inflammation;
various types of arthritis and arthrosis;
ankylosing spondylitis;
neuralgia with severe pain syndrome;
oncological diseases with painful manifestations;
inflammation of the tendons (tendenitis).

The main contraindication to the use of Ketonal injections, as well as other painkillers, is coronary artery bypass grafting.

Other contraindications include:

individual intolerance to the components of the drug;
diseases of the bronchopulmonary system;
insufficiency of cardiac activity;
ulcer of the stomach or duodenum.

Ketonal should be used with caution in such situations:

pathology of the liver and kidneys;
hemophilia;
lactation and childbearing; Carefully! Ketonal injections must be prescribed by a doctor with a clear calculation of the dosage and timing of use - no more than 5 days. Violation of these rules can lead to severe disorders in the work of the gastrointestinal tract. back to contents

Dexalgin

The drug for injection Dexalgin is a strong analgesic and is effective for inflammation. The active substance Dexalgin, when it enters the bloodstream, begins its work after 5-10 minutes. The persistent effect of anesthesia reaches 8 hours.

It is prescribed to relieve pain in the following conditions:

the period of postoperative rehabilitation;
radiculitis;
osteochondrosis;
neuralgia;
various injuries;
severe migraine.

Pain injections after surgery and in other cases are prescribed with caution for people with problems in the gastrointestinal tract.

pregnancy and lactation;
children's age up to 14 years;
various internal bleeding;
asthma;
angina;
stomach ulcer. Important! Dexalgin enhances the effect of opiates. Therefore, it is necessary to reduce the dosage of narcotic drugs when used in combination with this drug. It is also forbidden to combine Dexalgin with drugs of the same group (non-steroidal anti-inflammatory drugs), salicylates (Aspirin) and anticoagulants (Deltaparin). back to contents

Flamax

The drug is non-hormonal and anti-inflammatory agent. The main active ingredient (ketoprofen) is rapidly absorbed into the blood plasma, acting on the receptors that are responsible for pain. As a result, not only pain disappears, but also fever, chills. Due to the ability to inhibit the process of platelet aggregation, Flamax reduces blood clotting.

Indications for use:

pain after surgery, trauma;
articular syndrome;
muscle pain;
pathology of the spine with an inflammatory process;
inflammation of the pelvic organs.

As an additional therapy, it is used in the treatment of lymph nodes and veins.

It is prescribed with caution in the treatment of pregnant women and the elderly, hypertensive patients and asthmatics.

Completely contraindicated in:

ulcers, erosion, bleeding in the gastrointestinal tract;
hepatic or renal pathology;
low blood clotting;
children's age up to 15 years.

Pain injections after surgery (namely Flamax) can be combined with other forms of the drug and centrally acting analgesics (Akupan, Nalbufin).

diclofenac

The drug also belongs to the group of non-steroidal analgesics. Its main properties are:

Reduce tissue swelling.
Impact on the center of inflammation and its relief.
Reduced blood clotting by reducing platelet aggregation.
The ability to quickly reduce the intensity of pain for up to 8 hours. This property is especially valuable for the use of analgesic injections of Diclofenac after surgery.

The use of injections is justified not only in the postoperative period, but in the case of:

infectious diseases;
inflammation in the genitourinary system;
necrological disorders;
oncology;
bone pathologies;
injury to any part of the body;
diseases of the musculoskeletal system.

The use of the drug is possible in case of urgent need for bronchial asthma and pulmonary diseases.

Absolute contraindications are:

breastfeeding and pregnancy;
intestinal inflammation;
ulcer;
pathology of the circulatory system;
children's age up to 18 years;
intolerance to acetylsalicylic acid;
kidney and liver diseases. Carefully! Diclofenac injections should not be given before driving because they can cause loss of coordination. It is forbidden to combine the use of alcohol with the use of the drug. This can exacerbate the side effects of using the medicine. back to contents

Nimesulide

It has a triple effect on the body - relieves fever, pain and reduces inflammation. The active substance reduces the possibility of blood clots and promotes blood thinning. Influencing the process of histamine release, Nimesulide less often than other drugs causes bronchospasm.

A distinctive feature is the antioxidant effect by inhibiting the oxidation process and reducing the amount of harmful free radicals.

Application is shown in the following cases:

pain after surgery;
myalgia;
post-traumatic pain;
all types of arthritis;
bursitis;
inflammation of the respiratory system;
osteochondrosis.

Contraindications to the use of injections are:

chronic inflammation of the intestine in the acute phase;
bronchial asthma;
increased levels of potassium in the blood;
duodenal ulcer or stomach ulcer;
pregnancy and lactation;
children's age up to 12 years;
allergy or intolerance to individual components.

In hospitals and clinics, anesthetic injections after surgery are most often used. Analgesia can not only quickly and permanently improve the patient's well-being, but also help him recover without complications. Do not forget that the use of painkillers should be carried out only as directed by a doctor.

An ideal analgesic that does not have a negative effect on the body has not yet been invented. But the use of painkillers is the simplest and most inexpensive way to get rid of an unpleasant condition. It is much more difficult and longer to treat an already frolicking pain syndrome.

This video talks about how to give pain relief injections after surgery and not only on your own:

This video talks about painkillers and how to take them:

This video discusses the safety of pain medications:

The most powerful painkillers injections and drugs

If a person's pain intensifies, then strong painkillers are prescribed. Such drugs can only be prescribed by a doctor.

Many have significant contraindications.

In modern medicine, all painkillers are divided into 2 groups:

The most common among narcotic painkillers are drugs: morphine, codeine, they are classified as opioid drugs.

Also widely used are:

Anesthesia is carried out for the partial or complete disappearance of pain. Depending on the etiology of the disease and its symptoms, the severity of the disease, appropriate anesthesia is carried out, moreover, if painkillers in the form of tablets do not help, a person is given intramuscular or intravenous injections.

Application after surgery

After surgery, injections with a strong analgesic effect are most often administered in combination with other analgesics - paracetamol and narcotic analgesic.

Deserved attention in medical practice such drugs as:

An anesthetic injection of Ketorol relieves exacerbation in the postoperative period. Its main active ingredient is ketorolac, which helps to reduce severe pain. Contraindicated in people with drug intolerance, if there is an allergy to aspirin, ulcers, bronchial asthma, various postoperative bleeding, liver and kidney diseases. The drug should not be used for a long time.
Rofecoxib, or Denebol, is one of the most modern means, it is reliable and easy to use. Its properties are to suppress the synthesis of the inflammatory process. The drug has a long duration of action, is safe: it can be prescribed to patients with peptic ulcer.

Application in oncology

The strongest painkillers postoperative injections for oncology are divided into 3 groups:

Analgesics are prescribed depending on the stage of the disease and the degree of pain.

If the pain syndrome is very pronounced, opiates are used, with an average pain syndrome - non-narcotic content, with mild pain - auxiliary painkillers.

diamorphine is used to anesthetize only incurable patients when it is necessary to alleviate the patient's condition;
tramal is a narcotic analgesic that is rapidly absorbed into the blood, therefore, contributing to rapid pain relief.

Of course, the most powerful painkillers injections are drugs of the narcotic group, they are administered in the most severe forms of oncology and other diseases. They are of particular value, as they produce a strong analgesic effect in the postoperative period.

Hydromorphone, oxidone, morphine and other drugs are a kind of one group of substances that have general indications for use, differing in doses and time of use. They are considered the most powerful drugs.

These funds suggest complete relief from pain during the period of the active substance. Pain relief occurs almost immediately.

All drugs of the opiate group cause side effects, expressed depending on the drug (to a greater or lesser extent):

Opiate prescriptions are contraindicated if:

individual hypersensitivity to the drug;
in the case of conditions associated with respiratory depression or severe depression of the central nervous system;
with severe liver and kidney failure;
drug withdrawal syndrome.

In almost all cases where pain relief is needed, ranging from the simplest headache or abdominal pain to the most complex operations, modern medicine uses intramuscular and intravenous injections based on diclofenac, ketorolac or ketoprofen. Sometimes pills are prescribed.

Effective and proven pain relief injections in the joints

List of painkillers in the form of injections for joint pain:

Hydrocortisone is the best anti-inflammatory, anti-allergic agent; broad-spectrum drug. When administered, there is a caveat: an injection is injected into no more than 3 joints in one day, then a three-week break must be taken. The same joint can be treated only 3 times a year.
Prednisolone is the best analogue of hydrocortisone, it can reduce inflammation. It can not be used for a long time due to a decrease in the body's resistance to infections.

Use for back pain

Cases of the introduction of painkillers injections for back pain are as follows:

Inflammation of muscle tissue, hernia, backache, arthritis.
For pain in the lower back, neuroses of various etiologies, non-steroidal groups of drugs are used.
With lumbago, to restore the motor function of the body.

These drugs include:

Diclofenac is a fairly common pain reliever that can quickly, sometimes with a single injection, localize the pain syndrome, but it has strong side effects: this drug should be taken very carefully by people suffering from diseases of the stomach, liver, and kidneys. Since the medicine is strong, the course of treatment is usually 5 days. It is not recommended to take the drug for people with ulcers, chronic cholecystitis or gastritis, pregnant women and young children.
With hernias, betamethosone is administered, which contributes to the almost instantaneous elimination of the focus of inflammation. Betamethasone is not only an anti-inflammatory, but also an anti-allergic agent. You can not use the drug for skin tuberculosis, skin infections of various etiologies.
Ketonal - the best anti-inflammatory drug, is not only an anesthetic, but also an antipyretic. The substance is based on ketaprofen, which does not adversely affect articular cartilage, as a result of which it is prescribed for back muscle injuries, rheumatoid and reactive arthritis, myalgia, osteoarthritis, and sciatica. It is recommended to use with caution in the elderly.

Do not use Ketonal for:

ulcer;
pathologies of blood clotting;
severe renal, hepatic and heart failure;
various types of bleeding or suspected bleeding;
not recommended for children and pregnant women and women during breastfeeding.

Useful video on the topic

What else you need to read:

Use for painful periods

With menstruation, accompanied by severe pain, sometimes nausea, analgesic injections of No-shpa are prescribed. The main active ingredient is drotaverine hydrochloride. There is a specially designed formula for injections during menstrual pain.

do not use the drug in case of hypersensitivity to the drug;
with severe renal, hepatic or heart failure;
for medical reasons.

Pain relief medications after surgery

During the operation, tissues, muscles, bones are damaged, so the person feels pain. Pain medications after surgery help to relieve a person from pain, as a result of which the body recovers more efficiently. Pain is a signal that not all is well in the human body. It does not allow you to ignore the problem that has arisen. Each person relates to pain in their own way, has its own pain threshold. It is quite natural that every person who has undergone or is about to undergo surgery is interested in the question of what relieves pain after surgery.

Any operation is a huge stress for a person, and especially one whose pain threshold is low. The postoperative period is necessarily accompanied by significant pain, you need to understand this, but you don’t need to endure them. Therefore, after surgery, it is necessary to prescribe powerful analgesics that will help improve a person’s well-being and make the recovery period shorter and more effective. Painkillers, which are available in every home, are unlikely to help here. Pain injections are usually used immediately after the operation, and in the future, the doctor may prescribe pills.

Pain relief methods

After surgery, it is possible to use several types of analgesics:

tablets or syrups - means used orally;
ointments;
injections;
venous cannulas;
epidural catheter.

The easiest and most convenient is the oral route. When an epidural catheter is used, a person may experience pain, discomfort may occur, and inflammation of nearby tissues sometimes develops, but there are times when this method is simply necessary.

The essence of this method is that an analgesic is injected with a puncture needle into the region of the spinal cord, and then a catheter is attached. Often the use of this method is accompanied by unpleasant sensations:

nausea and vomiting;
headache;
drop in blood pressure;
weakness in the legs.

The least common side effects are observed when an anesthetic gel or ointment is used.

Tablets help relieve pain in about half an hour, while painkillers after surgery have their effect within 2-3 minutes. Therefore, in order to relieve pain after surgery, doctors prescribe injections. Ointments and gels are more often used as an additional remedy.

The most modern method is autoanalgesia, but in order to use it, a medical institution must have the appropriate material and technical base. With this method, an infusion pump is used to deliver analgesics to the blood. It has a button with which the patient can independently regulate the amount of medication received.

What are analgesics

Modern analgesics are divided into 2 main groups - they can be narcotic and non-narcotic. Drugs are:

based on natural substances;
semi-synthetic;
synthetic.

These funds have a number of distinctive features:

They have a strong analgesic effect, this property is especially valuable after surgery.
They are able to have some psychotropic effect, improve mood, bring a person into a state of euphoria, as a result of which drug addiction may develop. Therefore, these drugs are used for a limited time.
Serious side effects may develop. Sometimes, when using these drugs, nausea and vomiting occur, cardiac activity is disturbed, and intestinal tone increases.

But these drugs are highly effective as strong painkillers. If you choose the right dose and use them for a short time, the risk of side effects is minimal. Narcotic drugs are dispensed in pharmacies only by special prescription from a doctor.

In non-narcotic drugs, the analgesic effect is much less pronounced, but they also have an anti-inflammatory and antipyretic effect, which is important immediately after surgery. But, in addition to the undoubted benefits, these funds can cause harm if used improperly. Their side effects are a negative effect on the mucous membrane of the stomach and intestines, kidneys.

Characteristics of narcotic painkillers

Morphine is one of the most powerful narcotic analgesics. An injection of this drug almost completely relieves a person of any pain. Morphine relieves pain in a few minutes and works for 5 hours.

Morphine is a powerful analgesic that other drugs cannot compete with. Therefore, lighter drugs are usually prescribed immediately after the operation, and Morphine is used only if they are not effective enough. There are serious contraindications for its use:

severe respiratory and hepatic pathologies;
epilepsy;
severe alcohol intoxication.

Morphine is available in the form of injections and tablets, the effectiveness of which is almost the same.

Morphine, among other components, is part of a drug such as Omnopon. This remedy has the same strong analgesic effect as Morphine. Its difference is in fewer side effects. It is available only in the form of injections.

Promedol is a synthetic analogue of Morphine. The analgesic effect is somewhat less pronounced, the duration of exposure is shorter than that of Morphine. It has almost the same side effects, with one exception - less depression of the respiratory center. Therefore, Promedol is used in cases where the use of Morphine is not possible, for example, when the patient has severe respiratory failure. Promedol is available in tablets and ampoules for injection.

Another synthetic opiate is Tramadol. It has a strong analgesic effect, differs in the duration of action - about 8 hours. Available in tablets and in solution for injection, they have almost the same effect. A distinctive feature of Tramadol: its use almost does not develop side effects. It is contraindicated only with severe alcohol intoxication and its use is prohibited for pregnant women.

Characteristics of non-narcotic analgesics

These drugs relieve pain much weaker than narcotic counterparts. Therefore, they are not used for the first time after the operation. First, opioid injections are prescribed, and then, after some time, drugs are used in tablets.

Painkillers after surgery Diclofenac take effect in about 30 minutes. The drug has a good absorption capacity, due to which its analgesic effect can manifest itself in any organ. Therefore, it is widely used in various types of surgical interventions. The gold standard - so it is quite justifiably called this remedy among analogues.

Usually, injections of the drug are first prescribed, and the transition to the tablet form of the drug is gradually made.

Diclofenac has one serious drawback - a wide range of side effects. If it is used for a long time, the mucous membrane of the digestive tract is affected, a stomach or duodenal ulcer may occur.

Nimesulide has less side effects. This is a more modern tool, which is more secure. Analgesic properties are almost equal to Diclofenac, but Nimesulide has a longer duration of action. But the drug is not available in the form of injections, but only in tablets. Therefore, immediately after the operation, its use is unjustified. If you use the remedy for a long time, the risk of side effects increases.

The most modern, reliable, safe and convenient of painkillers is Rofecoxib. It is produced, in addition to tablets, also in ampoules. Therefore, it is often used in the first days after surgery. A huge plus of the drug is that it is practically safe. It does not affect the digestive system, so even patients with peptic ulcer can take it without fear. It differs in the duration of exposure, well reduces pain.

Drugs available in every home

Means from this group can be purchased without a prescription at a pharmacy, and for sure everyone has them at home. Of course, their effectiveness immediately after surgery is rather controversial, since they have weak analgesic properties. But if some time has passed after the operation, the person has been discharged from the hospital, these analgesics can also be used to relieve residual mild postoperative pain.

These drugs include Ketanov. There are certain restrictions on its appointment. For example, it should not be taken by children under 16, pregnant and lactating women, people suffering from asthma, stomach ulcers and some other diseases. Otherwise, the drug is quite effective.

Analgin in modern medicine has a controversial reputation. He copes well with his main task, but at the same time, the hematopoietic system, kidneys, and liver are affected. Modern doctors believe that analgin should be used in extreme cases.

Aspirin and Paracetamol are weak analgesics. They have been used in medicine for a long time and have a number of contraindications. For example, aspirin has a negative effect on the mucous membrane of the digestive organs, and in children - on the liver.

However, any pain medication must be prescribed by the attending physician, especially in such serious situations as the condition after surgery. Currently, there are many modern means that can significantly improve the well-being of a person after surgery and help his body to fully recover.

How is anesthesia administered after surgery?

Pain is a protective reaction of the body. It signals a person about the problem and does not allow it to be ignored. After the operation, due to damage to tissues, muscles, bones, a pain impulse occurs, passing along the nerves to the brain. Taking analgesics makes it possible to block it, to carry out an effective recovery of the body after surgery, to save the patient from suffering.

Pain relief after surgery: goals and effectiveness

Postoperative pain relief is aimed at eliminating pain and creating good conditions for the recovery of the body. Each person has their own pain threshold and attitude towards pain. Poor-quality analgesia causes severe discomfort, unpleasant emotions, and interferes with sleep. To avoid this, drugs are prescribed even before the formation of a pain impulse, taking into account the degree of tissue damage, the patient's well-being. Anesthesia during pregnancy is carried out according to special schemes, taking into account the degree of benefit / risk for the mother and fetus.

Tip: for the correct measurement of pain, the so-called pain ruler is used (a ten-point scale of pain intensity). If you do not feel a significant effect from the analgesic, ask to have your score measured and make adjustments to the pain management regimen.

Methods of analgesia

Using an epidural catheter

After surgery, painkillers are prescribed orally (to be taken orally: tablets, syrups), topically in the form of ointments or injected into the blood, muscles with an injection, venous cannula, epidural catheter. The first method is the simplest, safest and most convenient. But the latter method often causes pain, discomfort, can provoke the development of inflammation at the injection site, but in some cases it is indispensable. When using an epidural catheter (before the operation, the anesthesiologist injects an anesthetic with a puncture needle into the epidural space between the hard shell of the spinal cord and the periosteum of the vertebrae, and then connects the catheter) during or after the intervention, the patient may feel unpleasant symptoms:

nausea, vomiting;
weakness in the legs;
violation of urination;
lowering blood pressure;
headache, back pain.

When using ointments, gels with an analgesic effect, the likelihood of side effects is minimal.

Different types of conduction anesthesia (plexus - affects the nerve plexuses, stem, epidural, spinal, when there is a blockade of the nerve trunks and plexuses above the operation site) allow for high-quality anesthesia during operations on the organs of the abdominal cavity, pelvis, limbs.

After surgery, pain in the legs appears very often. But this state should not last too long. If you try to maintain yourself properly, the rehabilitation period will be much shorter.

Surgery is a serious method of treatment, which is used in cases where conservative methods are useless or contraindicated. A successful operation does not guarantee full recovery. Whether or not further problems appear depends on how the postoperative period goes and how the person follows the instructions of the attending physician. Not everyone understands if the legs hurt after the operation, what to do and how to help yourself. It is important to consider the main causes of complications after surgical procedures and methods for their elimination.

What causes pain

After almost any surgical intervention, people experience pain. Depending on the type and duration of the operation, pain in the legs can accompany a person from several weeks to several months.

The occurrence of pain is a normal reaction of the body to third-party intervention.

It is rare that discomfort is relieved with the help of traditional painkillers. Usually, experts recommend taking narcotic painkillers for the first few days. To get them, the doctor will write a prescription.

After any operation, the body needs a recovery period. Until the wounds heal and normal processes in the tissues are restored, unpleasant postoperative consequences may be felt.

Pain after vein surgery

Legs often hurt after vein surgery. After such an intervention, it is very important to strictly follow all the instructions of the attending physician and not to miss the prescribed events. Violation of the regimen can lead to additional complications and delay the recovery process.

After surgery, you should beware of listening to the advice of friends and acquaintances who allegedly have already been in such a situation.

Although the general rules for recovery are the same for everyone, no one knows all the circumstances of the disease better than the surgeon who performed the operation.

So that the foot and lower leg do not hurt, it is important to follow a few simple rules:

wear special tights;
observe the correct mode of washing the operated leg;
monitor frequent changes in body position;
observe the dynamics of temperature;
monitor for decreased sensitivity of the limb.

In order not to hurt to step on the limbs after surgery, it is necessary to consider in more detail the rules of behavior for a speedy recovery and follow them steadily.

Wearing special tights

After most operations on the legs, especially if they were performed on the veins, specialists prescribe the wearing of tight compression stockings. These products do their job well and support normal blood flow well. For some types of interventions, the use of an elastic bandage may be recommended.

Compression stockings can be made in a variety of holding densities. It is determined only by a doctor, so it is worth purchasing such products only after consulting a specialist.

Even after operations on one limb, knitwear is required on both legs. The first weeks of recovery, wearing compression stockings is necessary at all times, regardless of the type of activity performed and the time of day.

In addition to wearing special underwear, it is important to monitor the position of the body during sleep. To prevent blood from accumulating in the lower extremities, it is important to maintain them at least 15 degrees above the body during rest.

Wash mode

When the caviar hurts, you need to think about the correct care of the limb after the surgery. It is important to understand that the first 10 days you can not wet your leg at all. Washing is carried out only after the removal of the seams.

If the operation was performed on the veins, then even after 10 days it is forbidden to use hot water for foot care. The best option for washing is warm water with baby soap. Do not rub the operated limb. You can use a soft sponge.

After washing, the leg should not be rubbed with a hard towel. The skin can be blotted with a soft cloth. It is important that it be devoid of fibers that can catch on the crust on the wound and re-injure it.

After each washing, the area near the wounds must be treated with an alcohol composition. Iodine is also suitable for these purposes. Under no circumstances should dried crusts be removed mechanically. This can cause bleeding and increase the risk of reopening the wound.

Within the next three months after surgery on the leg, you should refuse to visit saunas, baths, pools and other places of high humidity. It is not necessary to carry out epilation with the help of a depilator or wax in the area of the surgical field.

Body position and mode of work

In order for the recovery after the operation to go as quickly as possible and without complications, it is necessary to monitor how long the body is in one position. You can not stand or sit for a long time. The more often light loads are replaced by complete rest, the better. The blood must not stagnate.

Both after the operation and during the subsequent long period, it is vital for the patient to refrain from heavy physical exertion. It is strictly forbidden to lift weights or engage in very active sports.

To keep your feet healthy, it is important to be observant and careful. Especially in the period after surgery, it is worth being careful in public transport, protecting the limb from unnecessary injuries, clamps or blows.

Some people worry when they have hematomas after the operation and their legs hurt. Few people know what to do in such a situation. Someone begins to smear neoplasms with some kind of gels, ointments and compounds. However, without a doctor's prescription, it is strictly forbidden to carry out any therapeutic measures! Thus, you can cause serious harm to your health.

Various seals and bruises appear after most operations. This symptom does not require any special treatment. All neoplasms resolve on their own within six months.

Patient body temperature

It is well known that elevated body temperature is an indicator of the presence of inflammatory processes in the body. After most surgical interventions, an increase in this indicator can be observed. This is considered the norm.

In most cases, increased temperature can be observed within a month from the date of surgery. A specialist should be consulted if:

the temperature rose higher than 37.5 degrees;
it stays on for over a month.

If you carefully monitor the main indicators, any deviation from the norm can be noticed in a timely manner and the necessary treatment can be started.

Sensitivity needs to be taken care of.

After operations in the ankle area, skin sensitivity is often lost. If this phenomenon is temporary, it can be considered the norm.

In those situations where normal sensitivity does not return after 2-3 months, measures must be taken. Only a qualified doctor will be able to accurately determine the cause of the pathology and select the appropriate treatment.

What to do with prolonged pain

It happens that the pain does not go away after a few months. This should be a reason to consult with your surgeon. The attending physician will prescribe a series of diagnostic measures aimed at determining the cause of the disease. Most often, an ultrasound examination of the operated limb is performed.

For almost any postoperative pain in the legs, doctors give the following recommendations:

wearing compression underwear;
professional massage;
charger;
frequent change of body position;
moderate physical activity;
no overload;
decrease in the amount of fluid consumed;
temporary refusal to take hormonal drugs;
refusal to lift weights.

A good therapeutic effect for the recovery of the legs after surgical interventions is the adoption of a contrast shower for the legs. Do not use hot water. Pretty warm and cold. This process helps to improve blood circulation in the limbs and prevent congestion.

Pain after uterus removal

Sometimes, after surgery to remove the uterus, some complications develop, including pain in the lower extremities. This unpleasant procedure affects quite a few women after 45 years.

The first days after the intervention, the patient is under the close supervision of a doctor and all the complications that have arisen can be discussed directly with him. As a rule, in the hospital after such operations, patients are kept for 10 days until the stitches are removed.

The maximum pain syndrome develops during the first day after surgery. Both narcotic and non-narcotic drugs can be prescribed for pain relief. Severe pain is associated with significant soft tissue injury due to an incision in the cavity.

To maintain the condition of the legs even before the onset of unpleasant symptoms, it is worth using compression stockings. They can be replaced with an elastic bandage, however, in this case it is important to monitor the degree of tissue compression and prevent excessive pressure.

In order for the recovery after the operation to remove the uterus to be as quick and without consequences as possible, doctors recommend starting to get out of bed as soon as possible. Most often, the first walks are recommended within a day after the intervention. These simple measures will allow you to normalize bowel activity.

A few days after the operation, it is important to follow a diet. You can not eat heavy food. It is important that intestinal motility normalizes, and stool appears.

If, after the operation to remove the uterus, pain appeared in the legs, and the skin in these areas turned slightly red, thrombophlebitis may develop. This is a very serious disease that requires careful monitoring. In such situations, for prevention, in addition to compression stockings, the administration of anticoagulants is prescribed.

Dealing with other complications

To prevent various postoperative complications, the doctor may prescribe certain measures. It is very important to help the patient recover.

After abdominal operations, a course of antibiotics is prescribed. This is important, since many microbes are transmitted through the air and such therapy is needed to exclude possible infection of other internal organs.

Removal of the uterus in most cases is accompanied by a large blood loss. It is very good when the surgeon uses modern blood-saving methods and performs procedures such as hemodilution or reinfusion, and also uses an electrocoagulator instead of a conventional scalpel. Despite all the skill, after the removal of the organ, intravenous injections will be required to restore the volume of lost blood and stimulate the production of red blood cells.

In addition to the above tips, you can take into account a few more nuances.

Often, the postoperative condition is facilitated after the application of ice bubbles along the projection of diseased vessels. Each compress should not last more than 20 minutes. It is important to take care not to burn the skin with cold.

A sure way to keep the veins in good shape and speed up recovery after surgery is to walk at an average pace. Daily walks should last no more than half an hour. Such loads improve the condition of blood vessels and normalize blood microcirculation.

You should not selflessly endure pain if the usual folk methods of quenching it do not help. It is worth getting acquainted with the drugs prescribed by the doctor and start taking them. It is important to read the instructions before use. There are time limits on how much you can drink certain drugs. Do not exceed the established limits.

Recovery will be much faster if the person undergoing surgery does not gain weight. To do this, it is important to monitor nutrition. Do not abuse fatty and salty foods.

After 7-9 months, you can begin to engage in active sports that do not involve heavy lifting and heavy loads. Great for swimming, walking and running.

Pain after surgery is a complex response to tissue trauma during the procedure, which stimulates hypersensitivity of the central nervous system. The result is pain in the involved areas, including even those not affected by the surgical procedure. Postoperative pain can occur after any surgical procedure, be it minor dental surgery or triple heart bypass surgery. Postoperative pain increases the likelihood of post-surgical complications and prevents the patient from recovering and returning to normal life.

Why does postoperative pain occur?

Pain comes in two different forms: physiological and clinical.

Physiological pain comes and goes. It is the result of sensations of high intensity. It often acts as a safety mechanism to alert a person (for example, in the event of burns, scratches, or cuts).
clinical pain, on the contrary, it is characterized by increased sensitivity to painful stimuli around a localized area, and is also felt in neighboring, unaffected areas. During the operation, tissues and nerve endings are injured, which leads to pain in the incision. This injury overloads the pain receptors that send messages to the spinal cord. The resulting central sensitization is a type of spinal cord post-traumatic stress disorder that interprets any stimulation as unpleasant. This is why a person may feel pain when moving or touching physically in places far from the surgical site.

Pain after surgery is tolerated differently

People endure postoperative pain individually. Doctors note that some patients experience severe pain in the postoperative period, which requires large doses of painkillers, while others cope well without a lot of medication. Several theories have been put forward for this discrepancy regarding, for example, differences in body size or emotional well-being. More recently, biological evidence has been unearthed that indicates the birth of individuals with varying pain thresholds. Scientists have found that changes in the amino acid of one of the genes cause different levels of pain perception. This gene codes for an enzyme associated with brain neurotransmitters, .

How to ease the postoperative period

The goal of pain management after surgery is to reduce the amount of pain the patient experiences after the procedure. New research has shown that avoiding overuse of the nervous system can result in a less painful postoperative period. Prepared patients may need fewer drugs and may recover faster. In addition, with improved, less invasive surgical techniques, many patients do not have to stay in the hospital at all after surgery.

Some non-medical methods can help reduce postoperative pain:

Knowing about the surgical procedure and its aftermath can help reduce stress, which plays a big part in the perception of pain. The patient knows what to expect and therefore the fear of the unknown goes away.
Meditation and deep breathing techniques can also reduce stress. These methods lower blood pressure and increase oxygen levels, both of which are critical to recovery.
Hypnosis before and after surgery can calm and muffle the perception of pain.

Side effects of pain medications

Pain medications can have unpleasant side effects. For many people, they cause nausea, vomiting, and impaired mental functioning. NSAIDs can cause kidney failure, intestinal bleeding, and liver dysfunction. Some drugs are associated with acute renal failure. Early screening and careful monitoring can prevent most of these problems.

Denial of responsibility: The information provided in this postoperative pain article is intended to inform the reader only. It cannot be a substitute for the advice of a health professional.

Pain after surgery may prevent you from being active and moving freely. Pain relievers will help you walk, sit in a chair, and participate in therapy that should help you get well soon.

Pain can make it difficult for you to breathe deeply, cough when needed, and use an incentive spirometer (a device that you can use to do breathing exercises).

Pain after surgery can reduce your appetite, and pain relievers can help you eat well, which

very important for recovery.

Pain can make it difficult for you to concentrate and to be able to take part in your recovery. Pain relievers may help.

Which doctor should I contact if there is pain after surgery:

Are you experiencing pain after surgery? Do you want to know more detailed information or do you need an inspection? You can make an appointment with a doctor Eurolab is always at your service! The best doctors will examine you, study the external signs and help identify the disease by symptoms, advise you and provide the necessary assistance. You can also call a doctor at home. The Eurolab clinic is open for you around the clock.

The phone number of our clinic in Kyiv: (+3 (multi-channel). The clinic secretary will select a convenient day and hour for you to visit the doctor. Our coordinates and directions are listed here. Look in more detail about all the services of the clinic on its personal page.

If you have previously performed any studies, be sure to take their results for a consultation with a doctor. If the studies have not been completed, we will do everything necessary in our clinic or with our colleagues in other clinics.

Do you have pain in your body after surgery? You need to be very careful about your overall health. People do not pay enough attention to the symptoms of diseases and do not realize that these diseases can be life-threatening. There are many diseases that at first do not manifest themselves in our body, but in the end it turns out that, unfortunately, it is too late to treat them. Each disease has its own specific signs, characteristic external manifestations - the so-called symptoms of the disease. Identifying symptoms is the first step in diagnosing diseases in general. To do this, it is simply necessary to be examined by a doctor several times a year in order not only to prevent a terrible disease, but also to maintain a healthy spirit in the body and the body as a whole.

If you want to ask a doctor a question, use the online consultation section, perhaps you will find answers to your questions there and read tips on self-care. If you are interested in reviews about clinics and doctors, try to find the information you need on the forum. Also, register on the Eurolab medical portal to be constantly up to date with the latest news and information updates on the site, which will be automatically sent to you by mail.

How long does the suture hurt after surgery and how to speed up healing

The seam after the operation sometimes hurts for a long time. There are many reasons for this - internal suppuration, the formation of adhesions, rejection of the cross-linked material by the body, and others. To relieve pain, special drugs are used, which are prescribed by the doctor, taking into account the type of intervention.

How long does postoperative pain last? There is no exact answer, it all depends on the capabilities of the human body. Discomfort and even soreness at the initial stage of scarring can persist permanently or occur periodically.

The healing time is individual, but there are average indicators, they depend on the location of the postoperative wound and the type of surgical intervention:

the seam after abdominal intervention heals for two weeks;
wounds from laparoscopic surgery and removal of the appendix heal on the seventh day;
healing after circumcision with phimosis (narrowing of the foreskin) lasts a little longer than two weeks;
postpartum sutures in the perineum are scarred within 10 days;
after a caesarean section, the external sutures are removed on the sixth day;
the sutures made in the chest area are scarred the longest, sometimes it lasts a month or more.

Seams are divided into internal and external. For stitching tissues inside the body, catgut is used (sheep intestines are used to make the material). Its advantage is the ability to dissolve, such stitches do not need to be removed.

To connect the external cuts, synthetic or natural - linen or silk - threads are used. They are definitely taken out. In some cases, metal staples are used for stitching.

Complete growth of connective tissue in the area of the postoperative incision occurs within two to three months.

After the operation, the patient is prescribed painkillers. After heavy operations in the first two or three days, these are narcotic substances. But do not worry, because they do not cause addiction, but only relieve pain.

In some cases, pain medications may be recommended for admission even after the patient is discharged from the hospital. If the pain in the suture area persists at home, then you need to consult a surgeon. It is likely that healing is not going as it should.

Pain after surgery

After the operation is completed, the patient needs a mandatory rest, at least a few hours. Depending on the situation, it is advisable to stay at the clinic until the next day, or stay for a few days. It all depends on the degree of complexity of the actions performed by the plastic surgeon, as well as on how the patient feels.

If the operation was done with the use of local anesthetics, then their effect stops after a few hours. And in this case, the patient expects quite noticeable pain after the operation. To get rid of them, and feel comfortable, you should take an analgesic recommended by your doctor.

The most pronounced pain occurs immediately after surgery, and in the first hours after it. In this case, the amount of work done does not matter. Then pain after surgery subside smoothly. If the operation is small, then sometimes painkillers are not required at all, as the patient feels well.

When does pain disappear completely after surgery?

A day after plastic surgery, and in some cases even earlier, most patients claim that they feel only slight soreness in the surgical area. It is not noticeable all the time, but only in that situation if you touch it with your hands, or make a sudden movement.

The peculiarity is that the so-called pain threshold is different for each person. Many patients claim that they did not experience any pain at all after plastic surgery, and even refused analgesics themselves in the postoperative period. But there are also people who complain that they are in a lot of pain, they experience general weakness and even move with difficulty. After a couple of days, if you are worried about pain after surgery, then it is quite possible to use analgesics, for the purchase of which a prescription is not required.

What drugs to refrain from if there is pain after surgery?

Although the operations are well tolerated, it still makes sense to follow certain recommendations for the first week. For example, the patient should not take such popular drugs as aspirin and other drugs that include acetylsalicylic acid. They can contribute to bleeding.

When the first week ends, as a rule, patients declare that nothing hurts them. Residual effects in the form of minor pain appear only during active movement or touch. If the plastic surgery had a large volume, then in this area the soreness persists a little longer, and may remind of itself for several months in a row.

Postoperative pain is completely normal, and no surgeon will ever promise you that after the operation you will be active, cheerful, and pain will not bother you. Pain can vary in intensity, intermittent or constant. If a person makes any movements, for example, gets up, lies down, turns on his side, the pain becomes more acute. In addition, everything hurts after the operation during coughing, laughing, and even when taking a deep breath. Any procedures, including dressings, also add pain.

How to minimize postoperative pain

In order for the patient's body to be able to rest from pain, the doctor prescribes narcotic analgesics, or, more simply, drugs. Their effectiveness is very high, and the introduction of such drugs is carried out taking into account the time period, without waiting until the pain reaches a maximum, and the patient cannot bear it.

When it starts to hurt more, or if there is a dressing, the patient must change position, then the amount of the drug administered can be increased. And also in the form of a supplement and enhancement of the action of the drug, other analgesics are used.

Is it possible to overdose a drug?

Many patients, as well as their relatives, are frightened by the thought of drug addiction. In this regard, even when it hurts a lot after surgery, the pain is not suppressed to the necessary extent. Drugs are administered in a very precise dosage, and only when there is a real need for it. All medical personnel must constantly monitor the patient's well-being, and pay attention to whether there are any side effects associated with the use of a narcotic drug. Perhaps the appearance of nausea, confusion, excessive sedation. At the first opportunity, the attending physician immediately reduces the dose, and ordinary drugs that are not included in the group of drugs are prescribed as an anesthetic. It can be paracetamol, and other drugs.

Everything hurts after the operation - is it dangerous?

Despite the fact that the pain after the operation itself is not dangerous, it is very tiring for the patient, takes a lot of strength. When the surgeon cuts through soft tissue, the nerve fibers are damaged. Therefore, the sensitivity in a certain place becomes much higher. Also, the cause of pain is swelling of the tissues. By manipulating and performing the necessary actions, the doctor causes additional tissue injury. Relatives and medical staff provide maximum moral support to a sick person, which helps him to survive the difficult period after the operation.

What to do if the scar hurts after surgery

The surgical operation involves the dissection of tissues, and the applied sutures contribute to their fusion. Scar formation is inevitable. Wound healing is a complex biological process that takes weeks, sometimes months. It can be accompanied by various symptoms: swelling, itching, pain, discoloration. Why the scar hurts after surgery, we will consider in the article.

Features of scar formation after surgery

It will take months for the final formation of the scar after the operation. And even in a completely healed suture, biological changes occur. Only their course becomes slow, subtle and asymptomatic.

In the process that occurs in the tissues during the maturation of the postoperative scar, several stages can be distinguished:

Dissection of the skin and adjacent tissues provokes the release of active biological substances by cells.
Fibroblasts are attracted to the site of injury, and collagen production is triggered.
Scar tissue begins to form. At the site of the seam, a young pink-colored scar appears, rising above the level of the rest of the skin covering.
A month after the incision is made, the excess fibrillar protein is resorbed. The scar becomes lower, flatter, acquires a lighter shade. The fibers order their position and are placed parallel to the level of the skin.

The links of the normal process of scar formation are listed above. Often the course of scar formation occurs with a violation. This may be due to a number of factors:

the cause of the wound was a burn;
healing complicated by an abscess;
it is impossible to match the uneven edges of the wound;
there is a significant tension of the skin;
pathology is determined by the physiological characteristics of the body and the influence of weak immunity;
malformation is genetic in nature.

For the surgeon and the patient, the important points in the formation of the scar after the operation are its strength, quick, trouble-free healing and a neat appearance. Modern techniques used in surgery make it possible to monitor the formation of a scar and carry out their timely correction.

Duration and signs of normal healing

The duration of wound healing depends on the location, external and internal factors, size, type, complexity of the operation or excision, and the professionalism of the specialist.

Consider the periods of healing during surgical intervention.

Causes of pain during healing

It is impossible to answer unambiguously the question of why a fresh scar hurts. The reasons may be different. The behavior and condition of scars is influenced by external factors or postoperative complications that may appear after a few months:

A scar from appendicitis or a stomach below the seam can hurt due to the formation of a hernia, ligature infiltrate, adhesions, microcracks. The solution of gynecological problems by surgery can also be accompanied by similar problems.
Inflammation of the ligature (thread for internal sutures) is a common phenomenon that causes pain even several years after the operation.
Frequent stress on the scar can also provoke pain. If the scar is located on the heel, knee, crook of the arm, finger, buttock, then constant pressure or tension during flexion-extension can affect the sensation in it.
Rubbing with clothes.
The response of scar tissue to changes in atmospheric pressure.
Divergence of internal seams.

What to do

Before taking any measures for the treatment of pain in scars, it is necessary to determine the nature of their occurrence. To exclude serious pathologies, you should consult a doctor. During the examination, the doctor may prescribe anti-inflammatory and pain medications or prescribe a second operation. If discomfort causes contact with clothing, then you need to solve this problem by isolating the scar from rubbing.

Possible complications and prevention

Complications in the process of scarring of tissues can be an inflammatory process, suppuration, divergence of sutures, and the formation of fistulas. To avoid such pathologies, it is necessary to strictly follow all the doctor's instructions regarding the treatment of the surgical site with antiseptic agents. Then limit the load on the wound site. If the scar is located on an open area of the body, then it should be protected from the influence of sunlight.

To prevent the formation of ugly and large scars after an injury, you do not need to self-medicate. It is better to resort to the help of specialists. The surgeon may apply an atraumatic suture to reduce the wound surface. To avoid uneven and ugly scars in burns, skin grafting is performed and plastic surgery is used. Antiseptic procedures and regular dressings will help to heal quickly and protect the wound from infection, which also affects the formation of scar tissue.

Pain after surgery

Surgical interventions of moderate trauma can cause significant pain after surgery. At the same time, traditional opioids (morphine, promedol, etc.) are not suitable for patients after such operations, since their use, especially in the early period after general anesthesia, is dangerous for the development of central respiratory depression and requires monitoring of the patient in the intensive care unit. Meanwhile, according to their condition, patients after such operations do not need hospitalization in the intensive care unit, but they need good and safe anesthesia.

Almost everyone experiences some pain after surgery. In the world of medicine, this is considered more of a norm than a pathology. After all, any operation is an intervention in the integral system of the human body, therefore it takes some time to restore and heal wounds for further full functioning. Pain sensations are purely individual and depend both on the postoperative state of the person and on the general criteria of his health. Pain after surgery can be constant, or it can be intermittent, aggravated by body tension - walking, laughing, sneezing or coughing, or even deep breathing.

Causes of pain after surgery

Pain after surgery can be of a different nature. This may indicate the process of wound healing and tissue fusion, because during the surgical incision of soft tissues, some small nerve fibers are damaged. This increases the sensitivity of the injured area. Other causes of pain after surgery are tissue swelling. In addition, much depends on how carefully the doctor performs the operation itself and tissue manipulation, as this can also cause additional injury.

Symptoms of pain after surgery

A person may not associate the resulting pain with a previous operation. But there are a number of signs that will help determine the pain after surgery. First of all, you should pay attention to the general condition: pain after surgery is often accompanied by sleep and appetite disorders, general weakness, lethargy, drowsiness, decreased activity. Also, these pains can cause a decrease in concentration, difficulty breathing or coughing. These are the most obvious and easily recognizable symptoms of post-surgery pain and should definitely be seen by a doctor.

Pain after varicocele surgery

Varicocele is a fairly common disease these days. The disease itself is not life-threatening, but it causes a lot of problems for a man, both physiological and psychological. Pain after varicocele surgery can be caused by various factors. The most dangerous of them is damage during the operation of the pudendal nerve, which is located in the inguinal canal. Pain is felt in the area of the surgical wound and may be accompanied by a decrease in the sensitivity of the inner side of the thigh. Another reason why pain may occur after varicocele surgery may be an infectious process in the postoperative wound. To avoid this complication, it is worth doing dressings only with a specialist and, as far as possible, avoid contact of the operated area with all possible sources of infection. Also, pain after varicocele surgery may indicate testicular hypertrophy or atrophy. Thanks to modern medical technologies, after surgical procedures in most cases, and this is about 96% of those operated on, no complications occur, so pain should be a signal that you need to see a doctor, since there is always a chance to be among the 4% of other patients.

Pain after appendicitis surgery

Removal of the appendix is a fairly common and simple operation in our time. Most of the surgery is relatively easy and without complications. Most patients recover within three to four days. Pain after appendicitis surgery may indicate complications that have arisen. If the pain is cutting in nature, this may be a sign that a slight divergence of the internal seams has occurred, as a result of overexertion. Drawing pains after appendicitis surgery may indicate that adhesions are occurring, which can subsequently affect the functioning of other pelvic organs. If these pains are too sharp, then there is a possibility that the intestines are squeezed, which can have an unfavorable outcome without medical intervention. Stress on the intestines can also cause pain after the removal of the appendix, so it is worth carefully monitoring the diet in the first time after the operation. In addition, it is worthwhile to handle the postoperative suture as carefully as possible in order to avoid infection and suppuration in the postoperative area.

Abdominal pain after surgery

After abdominal surgery (as after any other surgical intervention), the tissues of the body need time to recover and heal. This process is accompanied by mild pain, which decreases over time. But if the pain in the abdomen after the operation becomes very intense, this may indicate some kind of inflammation at the site of the operation. Also, abdominal pain after surgery can cause the formation of adhesions. People with increased weather sensitivity may feel aching pain at the operation site, depending on the change in weather conditions. Abdominal pain after surgery may be accompanied by nausea, dizziness, burning in the postoperative area, redness. If such symptoms occur, you should consult a specialist.

Pain after inguinal hernia surgery

After an inguinal hernia operation, there is a slight pain syndrome for some time after the operation, which disappears as the sutures and tissues heal. After a short period of time after the operation, the patient can already move independently, but still feel pain in the abdomen when walking. Pain after inguinal hernia surgery may not always indicate problems with the scar. It can be pain of both neurological and muscular nature. But with heavy loads in the postoperative period, relapses may occur, which are accompanied by severe pain and require repeated surgical intervention. Pain at the site of the seam can be a sign of both external and internal divergence of the seams.

Pain after spinal surgery

Some time after spinal surgery, characteristic pains in the area of the operated area may occur. Most often, pain after spinal surgery indicates a poor-quality operation, which subsequently leads to the development of a postoperative scar - fibrosis. This complication is characterized by specific pain that appears after several weeks of well-being. Pain after spinal surgery in most cases has a neurological cause. It can also be relapses of the disease caused by improper adherence to the postoperative regimen. Pain after spinal surgery is felt by most patients, but as they recover, their intensity should decrease. Recovery usually takes three to six months. In case of too intense pain, there are a number of methods for solving this problem, from drug treatment to consultation with neurosurgeons and a second operation. Spine surgeries are among the most complex and dangerous operations and often entail complications, so no pain after spinal surgery should be ignored.

Back pain after surgery

Back pain often persists after surgery. This can be caused by a variety of reasons, such as scarring, neurological symptoms, various pinches or misalignments in the spine. To avoid complications after surgery, you need to carefully consider the doctor's recommendations regarding the rehabilitation program. You may also experience back pain after a caesarean section. This is a fairly common problem that should not be ignored, because during pregnancy and surgery there is a strong load on the woman's spine, and therefore various injuries can occur. Often, after surgical operations, pain appears in the lower back, in the lower back. This is due to the formation of adhesions and the negative impact of cicatricial changes. Pain between the shoulder blades often appears after breast surgery, with tension of the rhomboid muscle. Quite often, spinal anesthesia is used during operations, which can later cause aching back pain.

Headache after surgery

Headache after surgery is associated with the peculiarities of surgical procedures or signals an increase in intraocular pressure due to surgery. Also, headache after surgery can be a consequence of anesthesia, especially if the pain is accompanied by nausea and dizziness. This is a rather dangerous symptom, which in any case requires an urgent consultation with a neurologist or the doctor who performed the operation. After spinal anesthesia, complaints of headaches are more common than after conventional general anesthesia. Such a complication occurs if too large a hole was made in the spinal membrane, resulting in a significant increase in intracranial pressure. If in this case the pain is very strong, then the filling of the hole with blood is used. Also, headache after surgery can be a side effect of drugs that are prescribed for the postoperative period.

Pain after hemorrhoid surgery

If the pain after hemorrhoid surgery persists for a long period that exceeds the rehabilitation period predicted by the doctor, then the postoperative treatment is not enough or it is not effective in a particular case and requires immediate correction. Severe pain after hemorrhoid surgery may be the result of scarring. In cases where the scars are too dense, ruptures of the intestine may occur, which will be repeated each time in the process of defecation. Also, pain after hemorrhoid surgery may indicate the ingress of pathogenic microflora into the postoperative wound and, accordingly, suppuration. One of the unpleasant causes of pain can be a fistula, which requires serious treatment. Pain after hemorrhoid surgery should decrease as the wound heals and tissues regenerate.

Pain after abdominal surgery

During each operation, the entire human organ system takes on a huge load. This process is accompanied by a significant stress state, which is aggravated by the presence of pain after abdominal surgery. The reaction of the body to an open operation can last up to three days and be expressed in severe pain, fever or pressure, tachycardia. Because of this, quite often in patients during the rehabilitation period, a depressed mood appears and activity decreases, which significantly slows down the recovery process. Pain after abdominal surgery is relieved by opiate drugs, sedatives and anti-inflammatory drugs. While taking the drugs, there is a decrease in pain after abdominal surgery, the body temperature returns to normal, and motor activity increases. Over time, the body recovers almost completely, there may be complaints only of minor pain in the abdomen, which also completely disappears with time. After three to four weeks, subject to the rehabilitation schedule and diet, the body's activity stabilizes, swelling disappears, pain disappears and a scar forms.

Pain after lung surgery

If severe retrosternal pain appears after lung surgery, this is an alarming signal that you need to see a doctor. Such pain may be a symptom of pulmonary hemorrhage, which appeared as a complication after surgery. Also, pain after lung surgery may indicate the formation of adhesions. Adhesions themselves are not a disease and do not always require medical attention, but if the adhesions are accompanied by a cough, fever, and poor general well-being, then this may require treatment. Pain after lung surgery can occur with sudden physical activity, which may be a sign of inflammation or suppuration in the operated area. Operations on the lungs are very serious operations, as a result of which complications often occur. In the first time after surgery, the body is an order of magnitude worse supplied with oxygen, which may cause headache, difficulty breathing and tachycardia. It also increases resistance to diseases such as bronchitis or pneumonia. In addition, it is worth remembering that after surgery, the lungs increase in volume, filling the free space, which can lead to displacement of other organs in the chest. All this can cause pain after lung surgery.

Muscle pain after surgery

Most often, muscle pain after surgery occurs in young men. Pain syndrome, as a rule, is associated with the use of curare-like drugs during anesthesia, which relax the muscles. Such drugs are used in emergency situations or in cases where a meal has taken place shortly before the operation and the stomach remains full during the operation. Muscle pain after surgery is the result of anesthesia. Usually these pains are "wandering", they are symmetrical and affect the shoulder girdle, neck or upper abdomen. With a favorable course of the rehabilitation period, muscle pain after surgery disappears after a few days. Also, pulling pains in the muscles appear after laparoscopy and continue for some time until complete recovery. In addition, after a long time after surgery, aching pains in the muscles near the postoperative scar may remain, as a reaction to weather changes.

How to relieve pain after surgery?

Most people experience some degree of discomfort after surgery. Such pains can have a different character and duration and intensify with certain body positions or movements. If the pain becomes too severe, narcotic analgesics are usually used. These drugs are most effective in cases where the patient needs to get out of bed or the pain is unbearable and weaker painkillers do not help. In some cases, the dosage of these drugs may be increased or supplemented with other drugs. It should be noted that such drugs can cause addiction and negative reactions of the body, so they should be taken as needed and under the supervision of a doctor or medical staff. In no case should you take strong painkillers that have a narcotic effect on your own. This can lead to side effects such as nausea, excessive sedation, disruption of the favorable course of rehabilitation. It is worth contacting your doctor who will describe how to relieve pain after surgery, taking into account the individual characteristics of the surgical procedures and the body. For moderate pain, doctors recommend the use of non-narcotic analgesics. This is paracetamol, which, with the right dosage, practically does not cause any side effects from the body and has a high tolerance. There are many folk ways to relieve pain after surgery, but still, traditional doctors strongly advise against self-medication, since in the postoperative period the body is most susceptible to all sorts of irritants and may respond inadequately to self-medication.

To protect against pain after surgery with an emphasis on preventive (before injury and pain) protection, it is recommended to use the principle of multimodality and the use of an integrated approach. When drawing up a plan for postoperative analgesia, a number of general principles should be followed:

therapy should be etiopathogenetic (with the spastic nature of pain after surgery, it is enough to prescribe an antispasmodic, and not an analgesic);
the prescribed remedy should be adequate to the intensity of pain after surgery and be safe for a person, not cause pronounced side effects (respiratory depression, lowering blood pressure, rhythm disturbances);
the duration of the use of narcotic drugs and their doses should be determined individually depending on the type, causes and nature of the pain syndrome;
drug monotherapy should not be used; narcotic analgesic for pain relief after surgery in order to increase efficiency should be combined with non-narcotic drugs and adjuvant symptomatic drugs of various assortments;
anesthesia should be prescribed only when the nature and cause of pain are recognized and a diagnosis is made. Removal of a symptom of pain after surgery for an unidentified cause is unacceptable. In fulfilling these general principles, every physician should, as Professor N.E. Burov, to know the pharmacodynamics of the main range of painkillers and the pharmacodynamics of the main adjuvant drugs (antispasmodic, anticholinergic, antiemetics, corticosteroids, antidepressants for anxiety and suspicious conditions, anticonvulsants, neuroleptics, tranquilizers, antihistamines, sedatives), assess the intensity of pain after surgery and, depending on this apply the same tactics.

To ensure the unity of tactics, it is proposed to use a scale for assessing the intensity of pain after surgery. The “analgesic ladder” developed by the World Federation of Societies of Anesthesiologists (WFOA) acts as such a scale. Using this scale allows achieving satisfactory pain relief in 90% of cases. The scale provides a gradation of the severity of pain after surgery.

At the 3rd stage - minimally pronounced pain after surgery - monotherapy with non-narcotic drugs is performed to relieve pain.

At the 2nd stage, a combination of non-narcotic analgesics and weak opioids is used, mainly with their oral administration. The most specific and reliable option for pain relief after surgery seems to be the effect on the central link, therefore, centrally acting drugs are mainly used to relieve pain after surgery. Examples of such analgesics are butorphanol and nalbuphine.

Butorphanol tartrate is a kappa agonist and a weak mu-opiate receptor antagonist. As a result of interaction with kappa receptors, butorphanol has strongly pronounced analgesic properties and sedation, and as a result of antagonism with mu receptors, butorphanol tartrate weakens the main side effects of morphine-like drugs and has a more beneficial effect on respiration and blood circulation. For more severe pain, buprenorphine is prescribed. The analgesic effect of butorphanol tartrate with intravenous administration occurs within a minute.

Nalbuphine is a new generation of synthetic opioid analgesics. In its pure form, dozemg is used for postoperative pain relief during out-of-cavitary operations. With large intracavitary operations, monoanalgesia with nalbuphine becomes insufficient. In such cases, it should be combined with non-narcotic analgesics. Nalbuphine should not be used in combination with narcotic analgesics due to their mutual antagonism.

The direction of creating combined drugs with different mechanisms and temporal characteristics of action also seems promising. This allows you to achieve a stronger analgesic effect compared to each of the drugs at lower doses, as well as reducing the frequency and severity of adverse events.

In this regard, combinations of drugs in one tablet are very promising, which can significantly simplify the regimen of administration. The disadvantage of such drugs is the inability to vary the dose of each of the components separately.

At the 1st stage - with severe pain - strong analgesics are used in combination with regional blockades and non-narcotic analgesics (NSAIDs, paracetamol), mainly parenterally. For example, strong opioids can be administered sc or IM. If such therapy does not have a sufficient effect, drugs are administered intravenously. The disadvantage of this route of administration is the risk of severe respiratory depression and the development of arterial hypotension. There are also side effects such as drowsiness, weakness, nausea, vomiting, impaired peristalsis of the digestive tract, urinary tract motility.

Medicines to relieve pain after surgery

Most often in the postoperative period, it is necessary to relieve pain after surgery at the level of the 2nd stage. Let us consider in more detail the drugs used in this case.

Paracetamol is a non-selective inhibitor of COX-1 and COX-2, acting predominantly in the central nervous system. It inhibits prostaglandin synthetase in the hypothalamus, prevents the production of spinal prostaglandin E2 and inhibits the synthesis of nitric oxide in macrophages.

In therapeutic doses, the inhibitory effect in peripheral tissues is insignificant, it has minimal anti-inflammatory and antirheumatic effects.

The action begins quickly (after 0.5 h) and reaches a maximum in a minute, but remains relatively short (about 2 h). This limits the possibility of its use in the postoperative period.

In the treatment of postoperative pain, a 2001 systematic qualitative review of 41 studies of high methodological quality showed that efficacy at a dose of 1000 mg after orthopedic and abdominal surgery was similar to that of other NSAIDs. In addition, its rectal form has been shown to be effective in dosemg/kg once (1 study) or mg/kg multiple times (3 studies), but not mg/kg once (5 studies).

The advantage is the low incidence of side effects during its use, it is considered one of the safest analgesics and antipyretics.

Tramadol remains the fourth most commonly prescribed analgesic in the world, with over 70 countries using it. However, in 4% of cases, it is prescribed for the treatment of pain after surgery.

Tramadol, a synthetic opioid analgesic, is a mixture of two enantiomers. One of its enantiomers interacts with mu-, delta-, and kappa-opioid receptors (with greater affinity for mu-receptors). The main metabolite (Ml) also has an analgesic effect, and its affinity for opiate receptors is almost 200 times greater than that of the parent substance. The affinity of tramadol and its Ml metabolite for mu-receptors is much weaker than the affinity of morphine and other true opiates, therefore, although it exhibits an opioid effect, it belongs to moderately strong analgesics. The other enantiomer inhibits the neuronal uptake of norepinephrine and serotonin, activating the central descending inhibitory noradrenergic system and disrupting the transmission of pain impulses to the gelatinous substance of the brain. It is the synergism of the two mechanisms of action that determines its high efficiency.

It should be noted its low affinity for opiate receptors, due to which it rarely causes mental and physical dependence. The results obtained over the 3 years of drug research after its introduction to the market in the United States indicate that the degree of development of drug dependence was low. The vast majority of drug dependence cases (97%) were found among individuals who had a history of drug dependence on other substances.

The drug does not have a significant effect on hemodynamic parameters, respiratory function and intestinal motility. In postoperative patients under the influence of tramadol in the range of therapeutic doses from 0.5 to 2 mg per 1 kg of body weight, even with intravenous bolus administration, significant respiratory depression was not established, while morphine at a therapeutic dose of 0.14 mg/kg was statistically significant and significantly reduced the respiratory rate and increased the CO2 tension in the exhaled air.

Tramadol also does not have an inhibitory effect on blood circulation. On the contrary, with the on / in the introduction of 0.75-1.5 mg / kg, it can increase systolic and diastolic blood pressure (mm Hg). Art. and slightly increase the heart rate with a quick return to the original values, which is explained by the sympathomimetic component of its action. There was no effect of drugs on the level of histamine in the blood and on mental functions.

Postoperative pain relief based on tramadol has proven itself in elderly and senile patients due to the absence of a negative effect on the functions of an aging organism. It has been shown that with epidural blockade, the use in the postoperative period after major abdominal interventions and after cesarean section provides adequate pain relief after surgery.

The maximum activity of tramadol develops after 2-3 hours, the half-life and duration of analgesia is about 6 hours. Therefore, its use in combination with other, faster-acting analgesic drugs seems more favorable.

Combination of medicines for pain relief after surgery

Combinations of paracetamol with opioids recommended for use by the WHO and abroad are the best-selling combined pain relievers for pain relief after surgery. In the UK in 1995, the number of prescriptions of paracetamol together with codeine (paracetamol 300 mg and codeine 30 mg) accounted for 20% of all analgesic prescriptions.

The use of the following drugs in this group is recommended: Solpadeine (paracetamol 500 mg, codeine 8 mg, caffeine 30 mg); Sedalgina-Neo (acetylsalicylic acid 200 mg, phenacetin 200 mg, caffeine 50 mg, codeine 10 mg, phenobarbital 25 mg); Pentalgin (metamisole 300 mg, naproxen 100 mg, caffeine 50 mg, codeine 8 mg, phenobarbital 10 mg); Nurofen-Plus (ibuprofen 200 mg, codeine 10 mg).

However, the potency of these drugs is not sufficient for their widespread use for pain relief after surgery.

Zaldiar is a combination drug of paracetamol and tramadol. Zaldiar was registered in Russia in 2004 and is recommended for use in toothache and pain after surgery, back pain, osteoarthritic pain and fibromyalgia, pain relief after minor and moderate trauma surgery (arthroscopy, hernia repair, sectoral resection of the mammary gland, resection of the thyroid gland, saphenectomy).

One tablet of Zaldiar contains 37.5 mg of tramadol hydrochloride and 325 mg of paracetamol. The choice of dose ratio (1: 8.67) was made on the basis of the analysis of pharmacological properties and has been proven in a number of in vitro studies. In addition, the analgesic efficacy of this combination was studied in a pharmacokinetic/pharmacodynamic model in 1,652 subjects. It has been shown that the analgesic effect when taking Zaldiar occurs in less than 20 minutes and lasts up to 6 hours; thus, the action of Zaldiar develops twice as fast as tramadol, lasts 66% longer than tramadol, and 15% longer than paracetamol. At the same time, the pharmacokinetic parameters of Zaldiar do not differ from the pharmacokinetic parameters of its active ingredients, and there are no undesirable drug interactions between them.

The clinical efficacy of the combination of tramadol and paracetamol was high and exceeded that of tramadol monotherapy at a dose of 75 mg.

To compare the analgesic effects of two multicomponent analgesics - tramadol 37.5 mg / paracetamol 325 mg and codeine 30 mg / paracetamol 300 mg, a double-blind, placebo-controlled study was conducted in 153 people within 6 days after arthroscopy of the knee and shoulder joints. On average, the groups daily dose of tramadol/paracetamol was comparable to that of codeine/paracetamol, which amounted to 4.3 and 4.6 tablets per day, respectively. The combination of tramadol and paracetamol was more effective than the placebo group. According to the final assessment of the result of analgesia, the intensity of pain during the day was higher in the group of patients who were anesthetized with a combination of codeine and paracetamol. In the group treated with the combination of tramadol and paracetamol, a more pronounced reduction in the intensity of pain was achieved. In addition, adverse events (nausea, constipation) occurred less frequently with tramadol and paracetamol than with codeine and paracetamol. Therefore, the combination of tramadol 37.5 mg and paracetamol 325 mg reduces the average daily dose of the former, which in this study was 161 mg.

A number of clinical trials of Zaldiar in dental surgery have been conducted. In a double-blind, randomized comparative study conducted in 200 adult patients after molar extractions, the combination of tramadol (75 mg) with paracetamol was not inferior in effectiveness to the combination of paracetamol with hydrocodone (10 mg), but caused less side effects. A double-blind, randomized, placebo-controlled, multicenter study was also conducted in 1200 patients undergoing molar extractions comparing the analgesic efficacy and tolerability of tramadol 75 mg, paracetamol 650 mg, ibuprofen 400 mg, and the combination of tramadol 75 mg with paracetamol 650 mg after a single dose. LS. The total analgesic effect of the combination of tramadol and paracetamol was 12.1 points and was higher than placebo, tramadol and paracetamol used as monotherapy. In patients of these groups, the total analgesic effect was 3.3, 6.7 and 8.6 points, respectively. The onset of action during analgesia with a combination of tramadol and paracetamol was observed on average in the group at the 17th minute (at 95% confidence interval from 15 to 20 minutes), while after taking tramadol and ibuprofen, the development of analgesia was noted at the 51st (at 95 % confidence interval from 40 to 70 minutes) and 34 minutes, respectively.

Thus, the use of a combination based on tramadol and paracetamol was accompanied by an increase and prolongation of the analgesic effect, a faster development of the effect compared to that observed after taking tramadol and ibuprofen. The duration of the analgesic action was also higher for the combined drugs of tramadol and paracetamol (5 hours) compared with these substances separately (2 and 3 hours, respectively).

The Cochrane Collaboration conducted a meta-analysis (review) of 7 randomized, double-blind, placebo-controlled trials in which 1,763 patients with moderate to severe postoperative pain received tramadol in combination with paracetamol or either paracetamol or ibuprofen alone. An indicator of the number of patients who need analgesic therapy to reduce the intensity of pain by at least 50% in one patient was determined. It was found that in patients with moderate or severe pain after dental operations, this indicator for 6 hours of observation for the combined drug tramadol with paracetamol was 2.6 points, for tramadol (75 mg) - 9.9 points, for paracetamol (650 mg) - 3.6 points.

Thus, a meta-analysis showed a higher efficacy of Zaldiar compared to the use of individual components (tramadol and paracetamol).

In a simple, open, non-randomized study conducted at the Russian National Research Center for Surgery, Russian Academy of Medical Sciences, in 27 patients (19 women and 8 men, mean age 47 ± 13 years, body weight 81 ± 13 kg), with pain of moderate or severe intensity in the postoperative period, the introduction of Zaldiar was started. after full recovery of consciousness and function of the gastrointestinal tract. The study included patients with acute pain after surgery caused by abdominal (laparoscopic cholecystectomy, hernia repair), thoracic (lobectomy, puncture of the pleural cavity) and extracavitary (microdiscectomy, safenectomy) surgical interventions.

Contraindications to the appointment of drugs were: the impossibility of oral administration, hypersensitivity to tramadol and paracetamol, the use of centrally acting drugs (hypnotics, hypnotics, psychotropic, etc.), renal (creatinine clearance less than 10 ml/min) and liver failure, chronic obstructive pulmonary disease with signs of respiratory failure, epilepsy, taking anticonvulsants, taking MAO inhibitors, pregnancy, breastfeeding.

Zaldiar was prescribed in standard doses: for pain, 2 tablets, while its maximum daily dose did not exceed 8 tablets. The duration of analgesic therapy ranged from 1 to 4 days. In case of insufficient analgesia or no effect, other analgesics were additionally prescribed (promedol 20 mg, diclofenac 75 mg).

Pain intensity was determined using a verbal scale (VS). The initial intensity of pain was recorded, as well as its dynamics within 6 hours after the first intake of Zaldiar; assessment of the analgesic effect on a 4-point scale: 0 points - no effect, 1 - insignificant (unsatisfactory), 2 - satisfactory, 3 - good, 4 - complete anesthesia; the duration of the analgesic action; the duration of the course; the need for the introduction of additional analgesics; registration of adverse events.

Additional administration of analgesics was required in 7 (26%) patients. Throughout the entire observation period, pain intensity according to VS ranged from 1 ± 0.9 to 0.7 ± 0.7 cm, which corresponds to pain of low intensity. In only two patients, the use of Zaldiar was ineffective, which was the reason for discontinuation. The remaining patients rated pain relief as good or satisfactory.

Pain after surgery of moderate intensity according to VS occurred in 17 (63%) patients, severe - in 10 (37%) patients. On average, the intensity of pain in the group according to VS was 2.4 ± 0.5 points. After the first intake of Zaldiar, adequate pain relief was achieved in 25 (93%) patients, incl. satisfactory and good/complete - in 4 (15%) and 21 (78%), respectively. A decrease in pain intensity after the initial dose of Zaldiar from 2.4 ± 0.5 to 1.4 ± 0.7 points was noted by the 30th minute (first assessment of pain intensity) of the study, and the maximum effect was observed after 2-4 hours, 24 ( 89%) of the patient indicated a clear decrease in pain intensity by at least half, and the duration of the analgesic effect was on average 5 ± 2 hours in the group. The average daily dose in the Zaldiar group was 4.4 ± 1.6 tablets.

Thus, the appointment of Zaldiar in case of severe pain after surgery or moderate intensity is advisable from 2-3 days of the postoperative period, 2 tablets. In this case, the maximum daily dose should not exceed 8 tablets.

The tolerability profile of Zaldiar, according to various studies, is relatively favorable. Side effects develop in % of cases. So, in a study in the treatment of osteoarthritis, nausea (17.3%), dizziness (11.7%) and vomiting (9.1%) were noted. At the same time, 12.7% of patients had to stop taking drugs due to side effects. No serious side effects were recorded.

In a study in postoperative patients, the tolerability of drugs and the frequency of adverse reactions during anesthesia with the combination of tramadol 75 mg / paracetamol 650 mg were comparable to those in patients taking tramadol 75 mg as the only analgesic. The most common adverse events in these groups were nausea (23%), vomiting (21%) and drowsiness (5% of cases). Discontinuation of Zaldiar due to adverse events was required in 2 (7%) patients. None of the patients experienced clinically significant respiratory depression or an allergic reaction.

In a four-week multicentre comparative study of the use of tramadol/paracetamol combinations (Zaldiar) and codeine/paracetamol in patients with chronic post-surgical back pain and pain due to osteoarthritis, Zaldiar showed a more favorable tolerability profile compared to the combination of codeine/paracetamol (these side effects were observed less frequently). effects like constipation and drowsiness).

In a meta-analysis of the Cochrane Collaboration, the incidence of side effects when using the combination drug of tramadol (75 mg) with paracetamol (650 mg) was higher than for paracetamol (650 mg) and ibuprofen (400 mg): an index of potential harm (a measure of the number of patients treated which developed one case of a side effect) amounted to 5.4 (with a 95% confidence interval from 4.0 to 8.2). At the same time, monotherapy with paracetamol and ibuprofen did not increase the risk compared with placebo: the relative risk index for them was 0.9 (with a 95% confidence interval from 0.7 to 1.3) and 0.7 (with a 95% confidence interval from 0.5 to 1.01), respectively.

When assessing adverse reactions, it was found that the combination of tramadol / paracetamol does not lead to an increase in the toxicity of the opioid analgesic.

Thus, when relieving pain after surgery, the most appropriate is the planned use of one of the NSAIDs in the recommended daily dose in combination with tramadol, which allows to achieve good analgesia in the active state of operated patients without serious side symptoms characteristic of morphine and promedol (drowsiness, lethargy, hypoventilation of the lungs). ). The tramadol-based postoperative analgesic technique in combination with one of the peripheral analgesics is effective, safe, and allows the patient to be anesthetized in a general ward, without special intensive monitoring.

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Everything hurts after the operation - is it dangerous?

What to do if the scar hurts after surgery

Features of scar formation after surgery

Duration and signs of normal healing

Causes of pain during healing

What to do

Possible complications and prevention

Pain after surgery

Causes of pain after surgery

Symptoms of pain after surgery

Pain after varicocele surgery

Pain after appendicitis surgery

Abdominal pain after surgery

Pain after inguinal hernia surgery

Pain after spinal surgery

Back pain after surgery

Headache after surgery

Pain after hemorrhoid surgery

Pain after abdominal surgery

Pain after lung surgery

Muscle pain after surgery