After surgery, patients generally experience pain lasting for about 5 to 7 days. The Inpatient Acute Pain Service at Columbia University is here to help you recover quickly with the least amount of pain. We believe that controlling pain is important not only to make you more comfortable, but also to allow you to participate in activities that promote recovery from surgery.

In the Acute Pain Service we emphasize the need for accurate pain assessment and use a numeric scale to assess pain. The scale ranges from 0 to 10 in which 0 = "no pain" and 10 = "the worst pain imaginable". Once your pain has been assessed you will be provided with the appropriate choices for managing your pain. Some of the choices are as given below:

1. Oral pain medication

When you are able to eat or drink after the surgery your pain will be treated with an oral pain medication. The best time to request pain medication is when you start feeling pain, not when the pain has become, unbearable. Remember that it is easier to treat lower levels of pain than it is to treat higher levels.

2. IM Injection

Intra-muscular (IM) injection is one of the methods to administer pain medication to you. This approach is used before you are able to take oral medications. When you have pain, just call for the nurse and if appropriate she will give you an injection in your arm or buttocks, as ordered by your doctor.

3. PCA

PCA (Patient Controlled Analgesia) is a way to deliver pain medication directly into your veins. You will push the button, whenever you feel pain within certain guidelines. The button is connected to a special pump that contains pain medication. The pump will deliver a set amount of medication, each time you press the button. A member of the Acute Pain Service can change the amount of the pain medication you receive according to your pain level.

4. Epidural Infusion

An epidural infusion is a way for you to receive pain medication without an injection. The pain medication is given through a thin tube placed into your back. An epidural provides excellent pain relief during the postoperative period. It makes you less drowsy so that you can participate in activities that help speed your recovery.

5. Continous Regional Anesthesia

Under certain circumstances a catheter, that is similar to an epidural catheter, may be placed alongside a nerve or group of nerves before surgery to your arm or leg. An infusion of local anesthetic is administered through the catheter to provide pain control that is limited to one arm or leg. You can also give yourself extra medication by pressing a button. This is particularly useful before you have physiotherapy. With this technique your pain can be controlled for as long as is needed.

Side Effects of Pain Medications?

The common side effects of any or all of the pain control methods described above are drowsiness, nausea, vomiting, itching, and urinary retention. There are many ways to manage the side effects of these medications. It is important to manage the side effects without discontinuing your pain therapy.

At Columbia, the Acute Pain Service consists of anesthesiologists and nurse practitioners. The referral process is simple - Your surgeon will need to call the Acute Pain Service Team when it is appropriate. However, you can also initiate the process by asking your surgeon to obtain a consult from the pain team.