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P A I N
C O N T R O L
SUBJECTIVE SCORES
Surgery Is Supposed to Hurt
Educate patients about how
REALITY CHECK Patients who
want to be pain-free after surgery
they'll really feel in recovery
have unrealistic expectations.
and why your pain control
regimen is designed to limit narcotic
use. Pre-op conversations should
alert them to the fact surgery will
cause some pain, but your care team
and anesthesia provider will do
whatever they can to prevent the
pain from becoming unbearable.
Patients who are properly educated
about surgical pain and enter the experience with realistic expectations
about how they'll feel in recovery won't overrate their pain and push caregivers for more drugs to control their discomfort.
Recovering patients are often asked to rate their discomfort on a 1-to-10
pain scale, which is used to determine if and when patients receive narcotics. For example, perhaps patients reporting their pain as 6 or higher will
receive the powerful drugs. But the scales are totally subjective. Pain that
one patient describes as 7, another might describe as 2.
What are anesthesia providers supposed to do with that subjective information? They must instead assess how patients are acting. For example,
when my patients complain of severe pain, I check their heart rates, blood
pressure and respiratory rates, which could all be elevated. Beta-blockers
could impact the heart rate and blood pressure, but the breathing rate is an
excellent indicator of a patient's level of comfort. Patients in pain have rapid,
shallow breathing. A comfortable patient does not.
— Ashish Sinha, MD, PhD, DABA
