Pain therapy after surgery.

After an operation, pain should be kept as low as possible so that breathing, coughing and taking the first steps are easier. This is achieved with painkillers on a fixed schedule, a push-button pump and thin pain catheters.

  • Painkillers on a schedule
  • Push-button pain pump
  • Catheter in the back or at a nerve

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  • Plannedin advance, in the consultation before anaesthesia
  • 0–10point scale used to measure pain
  • Daysfor which a pain catheter can stay in place
  • Tabletsas soon as you can eat and drink again

Typical values. Which methods are suitable will be clarified in your consultation with the anaesthetist.

Pain after surgery

Why pain is treated.

After an operation, the wound hurts – a normal reaction of the body to the procedure. How much depends on the operation and varies from person to person. Larger procedures on the abdomen, chest or bones and joints are among the more painful ones. Unlike chronic pain, this pain has a clear cause and eases as the wound heals.

Relieving it is about more than comfort. Anyone who breathes shallowly, hardly coughs and stays in bed for a long time because of pain has a higher risk of pneumonia or thrombosis. Severe pain that is not adequately treated can delay recovery and in some cases become chronic.

Treatment therefore relies on several building blocks. Painkillers with different modes of action are combined and given on a fixed schedule. If that is not enough, a pain pump is added that patients operate themselves: patient-controlled analgesia, or PCA for short. After major procedures, a thin catheter close to the spinal cord or at a nerve in the arm or leg can dampen pain transmission for days. Cooling, good positioning and early movement complement the medication.

Pain is measured on a simple scale from 0 for no pain to 10 for the worst pain imaginable. The aim is not necessarily zero, but a score at which breathing, coughing, getting up and sleeping are comfortably possible. What counts is how the patient feels – which is why nurses and doctors ask regularly.

The treatment

Three ways to relieve pain.

On a schedule

Several painkillers with different modes of action are combined and given at fixed times, not only once it hurts. This way, each drug can be used at a lower dose.

At the push of a button

The pain pump delivers a small, preset dose into the vein as soon as you press the button. A lockout period and a maximum dose protect against too much.

Via a catheter

A thin tube in the back or at a nerve in the arm or leg continuously blocks pain transmission, often for several days.

The procedure

From the first consultation to going home.

Pain therapy begins before the operation and does not end in the recovery room. Each phase has its own methods.

  1. Preliminary consultation

    The plan is agreed with the anaesthetist: which drugs, whether a pump or catheter makes sense, and which of your own medicines should be paused. Experiences from previous operations are part of this.

  2. Surgery

    Catheters and nerve blocks are usually placed before or during the procedure. The first painkillers are already working before the anaesthetic wears off.

  3. Recovery room

    Specialist nurses ask about pain early on, give extra medication if needed and explain how the pump works.

  4. Ward

    Nurses and doctors regularly ask about the intensity of the pain and adjust the treatment. Catheters and insertion sites are checked daily.

  5. Transition

    Once the pain eases and eating and drinking are going well, the pump and catheter are removed and replaced by tablets.

  6. Discharge

    A pain plan for home sets out what to take and when, and when to reduce it. The discharge letter keeps your GP practice informed.

Statutory and private insurance

Part of the treatment.

Statutory health insurance

Covered with the operation.

Pain therapy is part of the operation and the hospital stay. If the procedure is medically indicated, German statutory health insurance covers it too; in Wertheim, patients with statutory insurance are treated at the Bürgerspital, a hospital with a public healthcare mandate.

Private insurance or self-pay

Under your policy or at your own expense.

Private health insurance and Beihilfe (the German healthcare allowance for civil servants) reimburse pain therapy together with the operation according to their terms. Patients with private insurance and self-pay patients can also have their operation at Main-Tauber-Klinik, the private clinic under the same roof.

Specialists

Your doctors at a glance.

Pain therapy after operations is the responsibility of anaesthesiology: the anaesthetists plan it in the preliminary consultation, place catheters and look after pumps and catheters together with the nursing staff until the switch to tablets.

  • Mohamed AburawiSpecialist in AnaesthesiologyWertheim
  • Christoph BinasSpecialist in Anaesthesiology, pre-hospital emergency physicianWertheim
  • Rachel DorschSpecialist in Anaesthesiology, pre-hospital emergency physician, physician responsible for transfusionWertheim
  • Maria Eckert-KufnerSpecialist in Anaesthesiology & Intensive Care Medicine, pre-hospital emergency physicianWertheim
  • Claus HahnSpecialist in AnaesthesiologyWertheim
  • Erando JubicaSpecialist in Anaesthesiology, pre-hospital emergency physicianWertheim
  • Mihai NitaSpecialist in AnaesthesiologyWertheim
  • Dr. med. Stephan RappSpecialist in AnaesthesiologyWertheim

Locations

Where treatment takes place.

Each clinic shows on its own website how the treatment works there.

Frequently asked questions

Good to know.

How much pain will I have after the operation?

That depends on the procedure and varies from person to person. The aim is to keep pain low enough that deep breathing, coughing, getting up and sleeping are possible. If you feel pain, say so early – then the treatment can be adjusted quickly.

How does the pain pump work?

It is connected to the IV cannula. Pressing the button releases a small, preset dose; the pump is then locked for a few minutes, and a maximum amount is programmed in. Only the patients themselves press the button, never relatives. Anyone who is not sure they understand the principle receives the medication another way.

Can I become dependent on the painkillers?

With short-term use under medical supervision after an operation, the risk is small, but not zero. Strong painkillers are therefore only given for as long as necessary and are reduced or stopped before discharge.

What side effects are possible?

Strong painkillers can cause nausea, drowsiness, itching, constipation and problems passing urine; dangerous suppression of breathing is rare and is picked up early through monitoring. A catheter in the back can lower blood pressure or make the legs feel heavy. Bruising and infection at the insertion site are rare.

How long does a pain catheter stay in?

Usually a few days, until the wound pain eases and tablets are enough. The insertion site is checked daily. Removing the catheter takes only seconds.

Can I get up with a catheter in place?

Yes, and with less pain it is often easier. A nurse helps you the first time you get up, because strength and sensation in your legs may be reduced.

What applies after day surgery?

Discharge includes a pain plan for the first few days. The medication is taken according to the plan, not only when the pain is severe. If the pain suddenly gets worse, or if fever and a reddened wound develop, a doctor should take a look.

Further reading

More on the topic.

In-depth articles from the group's clinics.

Consultation

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