Total Joint Replacement Pain Management

At Duke we place priority on managing your pain, but we need your help. With your assistance and cooperation in communicating your pain, we will work with you to establish a realistic pain relief goal and ways to achieve this goal.

You will be asked often if you are having pain. Your answers should convey:

• What type of pain you are having. Words you may find helpful to describe your pain include: sharp, dull, stabbing, shooting, burning, crushing, or pins and needles.
• How much pain you are having. You can describe the intensity of pain on a scale of zero to 10. On this scale, zero is no pain and 10 is the worst pain you can imagine. Other scales are available. The staff will work with you to find a scale that you find easiest to use.
• Where the pain is located. Is it at the surgical site or somewhere else? Does the pain stay in one place or does it move?

Pain Management After Surgery

There are four possible ways to manage your pain after surgery. Your doctor will discuss the recommended method of pain management with you.

For the first three options, you have control over the level of pain control, and only the you may push a button for more doses. The four methods are:

• Epidural catheter -- a tiny flexible tube inserted into your back through which pain medication is given
• Regional catheter (nerve block) -- a tiny flexible tube inserted next to a large nerve through which pain medication is given
• Patient-controlled analgesia (PCA) -- medication given through an IV
• Oral medications -- pain medications by mouth after the first or second day

Opiod Side Effects

Opioids (narcotics) are one type of medication that may be used to control your pain after surgery. Examples of opioids include morphine, hydromorphone, fentanyl, oxycodone, and OxyContin.

Every medication has side effects. Listed below you will find some of the most common side effects of opioids.

• Nausea and vomiting
• Itching
• Sleepiness
• Constipation

If you are experiencing side effects from your pain medication, let your nurse know. Other medication or dietary changes may be necessary to relieve your discomfort.

Other Ways to Relieve Pain

• Repositioning
• Cold or ice treatment
• Relaxation techniques
• Distraction -- television, music, or visitors