Reducing Pain Medications After Joint Replacement Surgery
Continue on a regular daily basis until needing no other pain relief- usually 6-12 weeks
Continue for 2 weeks after surgery. It can be safe to continue these for up to 6 weeks. However if you feel like you would still benefit from further use beyond 6 weeks please consult your GP. You can continue for longer but your GP may wish to consider any cardiovascular risk factors, kidney issues or stomach upset.
This medication may assist in improving your comfort levels during the first 2 weeks after surgery. It may help reduce your need for stronger opioid medications. It may also improve pain relief at night. However it can cause sedation and drowsiness and occasionally blurred vision and constipation. The usual dose is
25-75mg twice daily but if develop side effects during the day you can take at night time only or stop altogether. If you are still requiring strong opioids beyond 2 weeks you may continue to take pregabalin if well tolerated until your need for opioids reduces.
2 - 6 weeks: Usual total duration
6-12 weeks: Uncommon: needs further medical input
> 12 weeks: Rare: Important to see a pain specialist
AIM TO REDUCE AS SOON AS PAIN LEVELS IMPROVE
Typically patients experience most pain during exercises and walking. In the early stages of recovery (1st 2 weeks) opioids are very useful to facilitate mobilisation and exercises. Over time the expectation is that pain will gradually subside and activities will become easier. At any stage if the activity is causing excessive pain it may be preferable to modify the activity rather than simply increasing the amount of opioid taken.
Opioid medications are very useful in preventing and treating severe pain in the early recovery phase after surgery. However prolonged use can cause problems for some patients. The usual side effects are well recognised and understood. These include drowsiness, constipation, itch, confusion, dizziness, dry mouth and nausea. The less common side effects are potentially more serious and less well understood. These include altering the perception of pain so that over time the body becomes MORE sensitised to pain and less sensitive to the pain relief effects of the medication. This can lead to increased dosing requirements and potential dependency issues. Opioids can also suppress the immune system and increase the potential risk of joint infections.