Analgesia is often referred to as the inablilty to feel pain whilst still being conscious. The task of treading this fine line can vary enourmously with factors such as individual personality, general health, pre-existing medication, type of pain/injury or even gender, all generating possible inconsistencies to effect.
Simple pains such as minor sprains or headaches are normally controlled satisfactorilly with over the counter drugs such as ibuprofen and paracetamol however more severe pain such as that associated with spinal surgery normally needs a little more kick. There are various guides to help practitioners perscribe adequate pain relief, the most famous being the WHO Analagesic Ladder, however we have a slight advantage in elective surgery because we have a good idea what to expect.
In major posterior surgery, that is where the incision is made in your back, immediate post operative pain relief is controlled with a two pronged approach:
1) Patient Controlled Analgesia (PCA)
2) Patient Controlled Epidural Analgesia (PCEA)
The common factor you will see between both is that they are patient controlled. This is considered to be a vital component in the effective management of pain due to its subjective nature. Both delivery methods can provide a continuous background dosing to dampen down pain but also offer a top up or bolus option should it be needed.
These delivery systems will only be in situ for around 2 days after surgery but each of you will be reviewed on an indivdual basis. You will normally be placed on oral pain relief instead that will reflect the type and severity of any remaining pain. Although these two methods will be clearly explained to you prior to surgery it is worth noting how they work by reading the appropriate pages in the left hand column or clicking the orange links above.
In anterior surgery, that is surgery that uses an incision through your tummy such as the (ST)ALIF techniques, a separate method is uesed along side the PCA where needed. During the surgery a small catheter is placed into the rectus sheath (area of your abdominal muscle) and this is connected to a small vessel containing Local Anaesthetic. This is then infused at a controlled rate to help with the incision related pain. For some of you this alone with oral medication will control your pain very well but for those that struggle, there is also the option on the PCA.
For information about oral medication Click Here.
