An Arsenal of Weapons to Treat Pain in the Hospital

Newer options not only do the job but keep the mind clear, too.

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Your doctors and nurses want to keep you from suffering after surgery—to a point. Opiate-type drugs such as morphine can induce nausea and vomiting, hamper the return to normal of your digestive and respiratory functions, and affect your ability to communicate with your caregivers. So the idea is to minimize real pain but accept some discomfort.

Putting pain medication right at the source, where it is more effective and keeps the mind clear and other body parts unaffected, is an increasingly popular alternative with some procedures.

Taking control. A nerve block is one such approach. Following a knee operation, for example, a thin needle, guided by ultrasound, is placed next to the femoral nerve in the groin to deliver a long-acting drug similar to lidocaine. Epidural blocks, long used during labor, are another option. For an abdominal procedure, say, an epidural catheter is inserted near the spinal canal where the abdominal nerves branch off, and medication is pumped in. Patients may be allowed to control the pain themselves, pushing a button to release a monitored dose as needed. Pain control matters not just because it makes patients feel better, says Michael Ashburn, director of pain medicine and palliative care at the Hospital of the University of Pennsylvania. Uncontrolled, the body's response to the stress of surgery raises the risk of bleeding, stroke, and angina. The nervous system may change how it processes pain signals, possibly leading to chronic pain.

Even stoics should disclose pain to caregivers—both the degree and kind (such as throbbing and persistent). Your words take the measure of your pain better than any instrument can.

This story was originally reported on 7/15/07.