"Don't Be Afraid of Pain After Bone Surgery"
Pain after surgery is as unavoidable a fact as the operation itself, and pain during and after surgery is one of patients' worst fears. Bone pain after orthopaedic surgery in particular can become unbearable. But modern medicine now has a solution for this too. Thanks to pain-control methods, orthopaedics and traumatology specialist Prof. Dr. Levent Altınel says, "More comfortable and pain-free knee replacement operations are now possible."
Pain is hard to describe, and only the patient feels it. How strongly it is expressed varies from person to person, and it is also hard for the healthcare staff to understand and empathise with it. For these reasons, orthopaedics and traumatology specialist Prof. Dr. Levent Altınel says that understanding and preventing post-operative pain is something of an art, and that today, with careful pain monitoring and the use of methods and devices for pain control, a comfortable operation followed by a quick recovery is possible.
Measuring with pain scales…
Noting that any surgical procedure is always painful and uncomfortable, Levent Altınel explained that they use pain scales to determine whether a patient has pain after surgery and, if so, how severe it is. "On this scale pain is rated from 0 points, meaning no pain at all, to 10 points, meaning very severe pain. The patient is asked to express their pain as a number. Simple painkillers are given for mild pain, while stronger morphine-type painkillers are used for severe pain. Pain rises and falls from time to time, so the patient is asked about it at intervals to determine its severity. In this way the severity of pain is measured regularly and accurately. Thanks to this, simple painkillers can be given for mild pain, reducing the continuous use of morphine-group drugs."
An end to the fear of pain…
Orthopaedics and traumatology specialist Prof. Dr. Levent Altınel points out that coping with bone pain, which tops the list of the most distressing, severe and unbearable pains, is as important as the operation itself, especially after surgery, and that a good doctor must provide not only a correct operation but also pain control before and after it. "Before knee replacement surgery in particular, one of the biggest problems I encounter in my patients is 'fear of pain'. People become seriously anxious about the pain they will go through; this can even lead to psychological problems. I have had patients who were afraid not of the operation but of the pain afterwards, and who avoided surgery for that reason alone. The approach to pain is as important as the success of the operation. I attach great importance to pain, and to help my patients overcome their fears I reassure them right from the start by explaining in detail how we will beat the pain. When they are admitted for surgery, I apply all the necessary measures before and after the operation so that they have a more comfortable and less painful operation," he says.
Noting that there are many drugs and different methods for relieving pain, Levent Altınel stresses that in pain treatment, where they aim for maximum benefit and minimum side effects, treatment should begin before surgery, before the pain starts. Levent Altınel also gives this important information about the methods they use: "Pain is hard to stop once it has started. Surgery is clearly a painful procedure, so pain treatment should begin before the pain is felt. Paracetamol-group drugs given intravenously before surgery are meant to ease the pain before it starts. At the end of the operation, a mixture containing morphine can be injected into different areas inside the knee that will be sources of pain, reducing pain levels for 24 hours after surgery. In addition, epidural anaesthesia, with an epidural catheter placed in the patient's lower back, is effective in eliminating pain both during and after surgery. Thanks to morphine given through the catheter in the back, patients can get through the day after surgery comfortably."
Control with a pain button…
Emphasising that there are now many methods for coping with pain, Levent Altınel says this about the "pain button", which they use with great success in patients who are anxious or afraid of pain, especially in knee replacement surgery: "With patient-controlled analgesia (PCA) devices attached to the epidural catheter or an intravenous line after surgery, knee replacement operations, whose first days are especially painful, can be got through with only mild pain. The PCA device regularly gives the patient a set amount of painkiller and does not allow pain levels to rise. If pain increases after the patient moves, the patient presses a button connected to the device and gives themselves an extra dose of painkiller. In this way patients practically relieve their own pain. Unlike trying to stop pain by giving painkillers from time to time, this method never lets the pain build up, so severe pain does not occur. Instead of telling the nurse and asking for a painkiller, the patient feeling pain controls it themselves by pressing the button."
The information on this page is for general information only and does not replace an examination and diagnosis.