PAIN IN THE SURGICAL CLIENT
Pain is an almost universal phenomenon in instances of surgical intervention and trauma. Surgery is an invasive intervention with the intention of treating, controlling, curing, or stabilizing a medical problem, and it carries with it many risks. Despite these risks, the primary fear of clients who are about to have surgery is pain: Will it hurt? How much will it hurt? How will I (the client) deal with it? How can it be treated or prevented?
Surgical intervention is a treatment choice for countless conditions. It is used to repair traumatic damage in the case of accident or injury, treat congenital anomalies, remove foreign bodies, treat disease, reduce inflammation to relieve pain, improve function, change appearance, and assist with childbirth or as an exploratory or diagnostic procedure.
Pain after surgery may be the same as pain prior to the surgery, and it often continues through the recovery and postoperative periods as well as after discharge. The length of time that pain can be moderate or severe after surgery depends on the type of procedure, the length and complexity of the procedure, the patient’s condition at the time of surgery, and the pain relief provided throughout the perioperative period. The quality of pain relief provided during the perioperative period can impact the patient’s recovery experience in either a positive or negative manner and can affect long-term outcomes as well. For example, well-controlled pain improves recovery time and reduces the risk of complications such as pneumonia or blood clots. It also allows the individual to better complete tasks important in healing such as walking and deep breathing exercises (Cleveland Clinic, 2017). In addition to the physiological effects of inadequately treated pain, the increased emotional and physiologic distress can add to the pain experience and decrease the effectiveness of treatments being used to relieve pain (D’Arcy, 2011a).
Surgery can be emergent in nature (an emergency), unexpected, or planned (elective). When surgery is emergent or unexpected, pain management is usually focused on the intraoperative and postoperative experience. In other cases, such as when the operative procedure is elective, healthcare providers and patients have more time to develop a plan of care for preventing or managing pain both preoperatively and postoperatively, as well as provide the patient with adequate education about various pain management techniques.
Although prior preparation for surgery is the ideal situation for any patient who needs surgery, the healthcare team is responsible for effectively managing pain no matter what the cause or circumstance surrounding a surgical procedure. An operative procedure may be curative, restorative, controlling, or palliative. Considering the reasons for surgery, as well as prior preparation and the personal meaning of the procedure to the client, are all-important in planning for pain management.