Analgesia Options in the Day Surgery Environment
Selecting appropriate analgesia is an important aspect of patient centred care in the day surgery and recovery room environment. Analgesic options are determined by the type of surgery, expected levels of pain, and the patient’s medical history. Anaesthetists and nurses work collaboratively to reduce pain, while minimising side effects from medications in order to provide patients with the best outcome. Specific education regarding pain management including analgesia prior to discharge is essential to enable patients (and their carers) to understand and manage the options to achieve effective analgesia during their post-operative recovery when they are managing their own medications at home. Patients should also always be given advice on what actions to take if the pain increases, spreads, suddenly worsens, or is uncontrolled.
Analgesia choices for day surgery patients include:
- Non-opioid analgesics: Paracetamol is highly effective with low side effects and should be routinely included in post-operative regimes. Paracetamol also enhances the effects of opioid medications. Non-steroidal anti-inflammatory drugs (NSAIDs) need to be carefully evaluated on an individual basis as their side effects can have a significant impact on patients with contraindications such as NSAID induced asthma, or ongoing bleeding issues. Paracetamol and NSAIDs can be combined for a synergistic effect.
- Opioid analgesics: Used cautiously, opioids are an excellent option. The short half-life of fentanyl makes it a safe choice for intra-operative analgesia, whilst minimising respiratory depression side effects in the stage 1 and stage 2 recovery areas. Discharge prescriptions often include either panadeine forte or endone as these resolve the intense pain associated with the immediate post-operative period.
- Local anaesthetic blocks: This strategy is often used with specific procedures, such as dental and ophthalmic surgeries. These can include lignocaine, bupivacaine and ropivacaine. It is important to be aware of the expected block time to enable appropriate analgesia to be administered prior to it wearing off.
- Non-pharmacological methods: The use of ice packs or heat packs is a practical and low-cost making it a highly recommended strategy. It is routinely recommended in dental and orthopaedic procedures. Dependent upon the surgical site, TENS machines may also offer significant analgesic efficacy. Distraction by watching TV or reading a book is another effective method that is proven to help reduce pain levels and improve patient satisfaction.
References:
https://www.anzca.edu.au/documents/ps15-2010-recommendations-for-the-perioperative-ca.pdf
https://www.nps.org.au/australian-prescriber/articles/postoperative-pain-management-2
https://www.nps.org.au/australian-prescriber/articles/perioperative-analgesia
- 30 October 2023
- by Susan Helmrich
Get Medcast Plus
Become a member and get unlimited access to 100s of hours of premium education.
Learn More
Susan is the Head of Nursing Education for the Medcast Group.
DipAppScNsg, BN, CritCareCert, CoronaryCareCert, TraumaNsgCareCert, CertIV(TAE), MN(Ed), and GradCert(Ldrshp & Mgt).
The latest healthcare news from medcast
This blog explores the ALS Algorithm and looks at how Medcast are trialling an adaptation of the 2023 updated ANZCOR Adult Advanced Life Support flowchart. The aim is to test its useability as a cognitive aid in ALS training to reduce cognitive load,...
Heather (55 years) presents with chest pain, there are no clear aggravating or relieving factors reported. This clinical snapshot explores the presentation of undifferentiated chest pain in a GP clinic, emphasising the importance of a thorough histor...
Croup, a common childhood respiratory condition, can present unique challenges when it progresses to require intubation. This blog explores the intricacies of managing a child with croup who has a challenging airway, providing insights and strategies...
Isaac is a 2 year old child who has presented to the GP for the fourth time this month. His previous presentations have been for a sore throat and fever and more recently food refusal and complaints of a sore stomach. His mother is very concerned, an...
This podcast highlights the crucial role of PSA testing in diagnosing and treating prostate cancer, the most-diagnosed cancer among Australian males. Emphasising harm reduction, it discusses advancements since 2015 and supports active surveillance fo...
Explore the evolution of telehealth in Australia, from its rapid expansion to the recent permanence of telehealth items. Dr. Stephen Barnett and Loryn Einstein guide GPs through billing complexities, emphasising compliance and the need for ongoing ed...
Explore essential insights into waveform capnography for aiding the assessment of ventilation and perfusion and guiding appropriate clinical interventions to optimise patient outcomes. This blog summarises the key ways clinicians can interpret End-ti...
Explore online GP education's impact on prescriptions and testing. A randomised trial provides insights into enhancing healthcare safety and efficiency and while challenges exist, the study paves the way for improved patient outcomes.
This case study guides Australian clinicians in diagnosing a common women's health condition. It emphasises the importance of recognising symptoms like irregular periods, weight gain, and hirsutism and following updated guidelines to improve patient ...
Health professionals play a crucial role in providing evidence-based advice on alcohol, pregnancy and breastfeeding. The Every Moment Matters campaign features a range of evidence briefs, resources and a free, accredited eLearning course for healt...
Long COVID presents unique challenges for patients with chronic respiratory conditions like COPD and asthma. This article delves into the overlapping symptoms, inflammation, treatment implications, rehabilitation needs, and mental health consideratio...
Join Medcast. Get instant access to essential healthcare news, research and more.
Already a member? Log In