Very little with modern , multi-modal pain management techniques. In the past , both hip and knee replacement have been very painful procedures. As a rule , most people now are quite comfortable after surgery. The only people who do still have pain that is difficult to control are persons addicted to prescription narcotics prior to surgery. We use several different methods in combination to minimize post-operative pain:
- Minimally invasive surgical techniques are used whenever possible.
- Spinal anesthesia: The anesthesiologist will give you sedation , numb your skin and place numbing medication along with a long-acting narcotic into your spinal canal. This method cuts down on blood loss and blood clots , and it provides hours of pain relief.
- Local Anesthetic Infiltration: before closing your wound , we inject a local agent into your tissues to help provide post-operative pain relief.
- Platelet concentrate is used to decrease pain , speed up healing , and minimize blood loss during surgery.
- Ice Machine: A continuous circulation of ice water through a pad placed next to the surgical site aids in pain control and decreases swelling.
- B Patient-Controlled Analgesia (PCA Pump): This can be used for break-through pain control It allows you to push a button when you feel pain and cause Morphine or Demerol to be directly infused into your vein for immediate pain control (no need to wait for a nurse to bring pain medicine).
- Oral Narcotics: We use Oxycontin as a preemptive and continuous long-acting narcotic while you are in the hospital to prevent pain. Typically , Vicodin is used for additional pain control and is continued after the other methods (above) are no longer needed.
- Anti-Inflammatory Drugs: Celebrex or Mobic is given in the pre-operative holding area , used throughout your hospital stay and for one month post-op. These decrease the need for narcotics and improve pain control (The fewer narcotics a patient requires , the better , because the side effects include confusion , nausea , itching and constipation.)