Our protocol is very effective and patients are usually very comfortable. Every patient responds differently to medications. We follow a multimodal protocol that can be adjusted, as needed depending on individual patient response. We combine numerous agents to limit postoperative pain and keep our patients as comfortable as possible. The person who has taken a lot of narcotics before surgery is the hardest hit with pain afterwards.

On the other hand, sometimes people feel so comfortable that they stop all the medications when they leave the hospital and then pain catches up. We generally recommend 3-5 days of long-acting narcotic after surgery together with occasional short-acting narcotic as needed. In addition, round the clock Tylenol for 1 week and an anti-inflammatory medication for at least 2 weeks is recommended. An ice machine should be used regularly for 1 week.

True allergy to narcotics is rare indeed. Common side effects include nausea, itching, constipation, and mental changes. Some people are more sensitive to these side effects. They still need narcotics for surgery. Our protocol includes medications to limit these side effects. If narcotic dosage is decreased, side effects lessen, but pain increases. The patient must choose the right balance.

Switching from one specific narcotic to another is generally less effective than adjusting dosage. All narcotics cause these side effects; they are dose dependent effects. Certainly you need narcotics while you travel home. After 3-5 days surgical pain is usually to a point where narcotics are not needed on a regular basis.