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Patient-controlled epidural analgesia (PCEA) is a related term describing the patient-controlled administration of analgesic medicine in the epidural space, by way of intermittent boluses or infusion pumps. This can be used by women in labour, terminally ill cancer patients or to manage post-operative pain. [5]
Postanesthetic shivering is one of the leading causes of discomfort in patients recovering from general anesthesia. It usually results due to the anesthetic inhibiting the body's thermoregulatory capability, although cutaneous vasodilation (triggered by post-operative pain) may also be a causative factor.
Depending on the use of inhalation anesthestics, post operative nausea and vomiting (PONV) is one of the most common complications to monitor in the immediate postoperative period. [5] Patients do receive antiemetic medications, such as Ondansetron and Dexamethasone, during the surgical procedure if the patient is at risk for it.
Another problem with pain management is that pain is the body's natural way of communicating a problem. [6] Pain is supposed to resolve as the body heals itself with time and pain management. [6] Sometimes pain management covers a problem, and the patient might be less aware that they need treatment for a deeper problem. [6]
Post-mastectomy pain syndrome is a chronic neuropathic pain that usually manifests as continuous pain in the arm, axilla, chest wall, and breast region. [3] Pain is most likely to start after surgery, [3] although adjuvant therapy, such as chemotherapy or radiation therapy, may sometimes cause new symptoms to appear. [4]
The types of nerve activity targeted in preventive analgesia include pre-surgery pain, all pain-system activity caused during surgery, and pain produced post-surgery by damage and inflammation. [1] A person's assessment of pain intensity from standard experimental stimuli prior to surgery is correlated with the intensity of their post-surgery pain.
The WHO guidelines recommend prompt oral administration of drugs ("by the mouth") when pain occurs, starting, if the patient is not in severe pain, with non-opioid drugs such as paracetamol (acetaminophen) or aspirin, [1] with or without "adjuvants" such as non-steroidal anti-inflammatory drugs (NSAIDs) including COX-2 inhibitors.
After about ten months, the patient should be able to return to normal daily activities, although the operated leg may be significantly weaker than the non-operated leg. [67] For post-operative knee replacement patients, immobility is a factor precipitated by pain and other complications.