Pain Control After Surgery

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It is normal to have some pain after surgery. The goal of taking pain medications is to make you as comfortable as possible while keeping the risk of bad or bothersome side effects as low as possible. We want you to feel comfortable enough to get up, wash, get dressed, and do simple tasks in your home. Some discomfort is likely. We do not expect you to be completely free of pain.

The following recommendations are general guidelines for taking pain medications:

Unless your doctor gives you a different plan, ibuprofen is the main medicine you will use to manage your pain.
It is often beneficial to add acetaminophen to help manage pain.
You may also get a prescription for an opioid such as oxycodone. The opioid should be added as needed to reduce pain that is not adequately relieved by ibuprofen and acetaminophen.

If you cannot take acetaminophen (Tylenol®), ibuprofen (Motrin®), or oxycodone, please talk to your doctor about this.

How do I take Ibuprofen and Acetaminophen?

You will do better if you prevent pain by taking medication on a regular schedule instead of waiting until you are in pain. A typical schedule is:

8 am - eat breakfast and take 600 mg ibuprofen
11 am - take 650 mg acetaminophen
2 pm – eat a snack and take 600 mg ibuprofen
5 pm - take 650 mg acetaminophen
8 pm – eat a snack and take 600 mg ibuprofen
11 pm - take 650 mg acetaminophen
2 am – if you wake up on your own, eat a small snack such as a cracker and take 600 mg ibuprofen (you do not need to set an alarm).

600 mg ibuprofen = 3 regular strength Advil
650 mg acetaminophen = 2 regular strength Tylenol

When you are doing well with ibuprofen and acetaminophen on this schedule, you can decrease how often you take acetaminophen. Continue taking ibuprofen on a schedule.
When you are doing well with ibuprofen on this schedule alone, you can gradually decrease how often you take it. It is a good idea to take a 600 mg pill before you start a more tiring activity such as going shopping or for a long walk.
Once you get more active, you may have a day when your pain gets a little worse. If this happens, take 600 mg of ibuprofen. If ibuprofen does not relieve the pain, add acetaminophen 650 mg (2 Regular Strength Tylenol tablets).

Do not take more than 3,250 mg of acetaminophen (10 Regular Strength Tylenol® pills) in one 24-hour day. Remember that many pain relievers, such as Norco® and Percocet®, also contain acetaminophen. It is important to read labels.

What if this schedule does not control my pain?

If alternating ibuprofen and acetaminophen does not relieve your pain, add an opioid pain medication. Take the opioid as instructed by your doctor. For example, prescriptions for oxycodone usually say, “Take 1 to 2 pills every 4 to 6 hours as needed for pain.” Use the smallest amount of opioid that you need to control your pain. Reduce the number and frequency of opioids as soon as you can.
If your prescription is for Norco or Percocet (contains acetaminophen) be sure to count that acetaminophen dose toward your daily total (3,250 mg daily).
Adding heat or ice is also very helpful and can be used any time.
Do not push or press on your incision(s). It is normal for your incision(s) to be sore for up to 6 weeks if you push on them.

Important information about opioids:

Opioids are prescribed for short-term use and should be stopped as soon as possible after surgery.
Take the lowest dose of opioids only as needed, and do not take more opioid medication than your doctor has prescribed.
Common side effects and risks of opioids include drowsiness, mental confusion, dizziness, nausea, constipation, itching, dry mouth, and slowed breathing.
Never mix opioids with alcohol, sleep aids or anti-anxiety medications. These are dangerous combinations that increase the harmful effects of opioid pain medication. Many overdose deaths from opioids also involve at least one other drug or alcohol.
Keep opioid medications locked away from the reach of children. This also helps prevent theft.
It is illegal to sell or share an opioid without a prescription properly issued by a licensed health care prescriber.

What should I do with unused opioid pain medication?

Do your part to prevent opioid abuse by properly disposing of unused medication. Leftover pain medications make tempting targets for theft. They can also be dangerous if children or pets find them.

Safe Take-Back Locations

To find an opioid drop-off location in Indiana near you, type the following into an internet search engine such as Google or Bing: https://www.in.gov/bitterpill/take-back-locations/. This will take you to a web site with a map that shows all the opioid drop-off locations in Indiana.
To find drop-off locations in other states, use nabp.pharmacy/initiatives/awarxe/drug-disposal-locator

What do I do if there is no take-back location near me?

If there is no Take-Back program in your area, ask your local pharmacist how to safely dispose medicines in your household trash.

When should I restart taking my usual medications?

Before you leave the hospital, ask your doctor when you can restart aspirin or any blood thinning medications.
If you use vaginal estrogen, you may restart it two weeks after your surgery unless otherwise instructed by your doctor.
Otherwise, start back on your usual schedule as soon as you get home.