Pain control is necessary to give patients the chance to go home after an outpatient spine surgery. Successful outpatient surgery centers utilize a multifaceted approach to reduce pain and swelling after an operation.
Learn more: Getting Adequate Pain Control After Back Surgery
These are some of the modes often used to limit pain:
- The surgeon must be deliberate in reducing the size of exposure while still having excellent visualization of the surgical field.
- Dissection trauma must be minimized as much as possible.
- The skin area should be locally anesthetized. The deeper muscle and fascial layers should also be infused with anesthetic. Corticosteroid medications can be utilized to decrease longer-term swelling and inflammation.
- A combination of narcotic medications, muscle relaxers, and anti-inflammation medications can provide better pain control. Anti-inflammatory medications are not used for any type of fusion surgery, however, such as an ACDF or lumbar fusion.
- Ice and cool therapies can reduce the postoperative pain and swelling.
Depending on the patient’s medical history, not all these different techniques may be utilized.
Opioid Tolerance Affects Pain Relief
Patients having spine surgery may have been on opioids—also called narcotics or pain killers—at relatively high doses and/or for a prolonged period of time prior to surgery. If this is the case, they will have developed a certain level of tolerance for oral opioids and the medication may not be sufficiently effective in management of acute postoperative pain.
To address this issue, some surgeons will try to wean patients off the more potent narcotics prior to surgery. If opioid use prior to surgery can be decreased or eliminated it will to give the prescribed post-operative pain medications a chance to provide acute relief. If post-operative pain management is a concern, admission for inpatient observation may be a better choice.