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WHAT TO EXPECT?
If you are going for surgery or have had surgery recently, these topics may be important for you to know.
01
Common post-operation experience
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Operation site pain and swelling
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Sore throat or voice hoarseness
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Nausea or vomiting
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Headache
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Itch
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Weakness or numbness if a nerve block was performed
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02
Managing pre and post-operative pain
There are many ways one can deal with pre and post-operative pain. Pain is subjective and each individual may have different coping mechanisms for managing their pain. Choose the ones which best suit you in managing pain. You can discuss the options with your Anaesthetist to enquire which treatments would suit you best.
Medical treatments in managing perioperative pain
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Intravenous analgesia (pain killers)
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Single-shot nerve block
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Nerve block with a leave-in-catheter
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Epidural/ Spinal
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Local anaesthesia
Medical treatments in managing post-operative pain
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Oral analgesia
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Intravenous analgesia
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Intramuscular analgesia (injection)
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Patient-controlled analgesia (PCA)
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Nerve block
Non-medical techniques in managing post-operative pain
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Plenty of rest
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Deep-breathing exercise
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Music therapy
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Aromatherapy
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Adjusting mindset and expectation
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Distraction techniques
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03
What is a nerve block?
Simply put, a nerve block is blocking the nerve endings which activate the pain stimuli to your brain. There are two ways a nerve block can be administered.
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Single-shot nerve block
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Leave-in-catheter
In a single-shot nerve block, the anaesthetist infiltrates local analgesia (LA) to the targeted nerve by injecting a needle close to the nerve or group of nerves, with the aid of an ultrasound machine. After the LA has been administered, the needle is then removed immediately. For example, if you are going for a ACL reconstruction surgery, the anaesthetist may want to block your femoral nerve or the nerve in the adductor canal. By doing a single-shot nerve block, pain is controlled intra-operatively and post-operatively. Patients may require lesser painkillers for pain management subsequently.
In a leave-in-catheter, the anaesthetist threads in a thin catheter (tube) near the targeted nerve and leaves the catheter to continue giving medications post-operatively to block the pain. After surgery, this catheter may be connected to a pump which can continuously deliver local anaesthetic medication to reduce post-op pain. The catheter will be removed prior to discharge or when patient’s pain is more tolerable with oral pain killers.
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04
What to expect after a nerve block?
It is normal to feel numbness and weakness over the affected limb 6-24 hours after the procedure. Some people experience it for a longer duration of 2-3 days with eventual recovery.
Do not place any excessively hot or cold objects over the blocked area to avoid tissue injury.
Avoid driving or doing any activities involving the affected limb.
Inform your doctor if you experience rashes, redness and swelling over the blocked area or numbness persisting longer than 3 days.
When the block wears off, you may experience significant pain. Remember to take your oral painkillers regularly as prescribed.
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05
What is an extravasation?
Extravasation occurs when administered medicines spill out of the vein and leak into the surrounding tissues. It is a common complication, which may cause discomfort. On rare occasions, it can lead to more serious injury.
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Causes of extravasation:
• IV cannula slips out of the vein if not secured properly
• Weak veins due to age or illness
• Veins punctured more than once when the IV is sited (for example, a through and through puncture)
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Signs of extravasation:
Swelling, redness or other colour changes, or pain around the IV site
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Management:
• Apply a cold compress over the IV site
• Elevate the affected limb to reduce swelling
• Monitor the affected area daily and inform the doctor if it gets worse
• Inform the doctor if the pain over the area increases
• If required, hirudoid cream can be applied to reduce bruising
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The time taken to recover from extravasations differs from patient to patient depending on their age, mobility and co-morbidities. Most patients recover from extravasations in 2-3 days. Some patients take longer due to poor circulation and existing co-morbidities. If you need further clarification, do not hesitate to contact your doctor or nurse.
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