Q. How to manage post operative pain in Spigelian hernia surgery?

Answered by
Dr. Dineshkumar Murugesaboopathi
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jan 22, 2020

Hello doctor,

I am a 52-year-old female. I underwent a hysterectomy and abdominal floor reconstruction last week. Though I have never used any opiates other than during child birth and dental work. I found that neither the morphine pump nor Norco helped much with pain. However, I did get relief from Toradol. Now I am facing an open repair of a 5 mm Spigelian hernia which was found during the hysterectomy. I am worried about controlling pain. Will I get a similar relief with Toradol following this surgery? And if not, what other alternatives do I have?



Welcome to icliniq.com.

I can understand your apprehension about the pain. Spigelian hernia repair should be less painful and your experience should be better I hope. If you are very worried you could always ask for epidural analgesia for pain relief. The anesthetist in charge should be able to manage with his drug repertoire, opioid resistance is very unusual and in our experience, it is usually due to inadequate dosing. I would also recommend IV Paracetamol (Acetaminophen) in the post-operative period if that is available in your center.

In the later post-operative period at home, I would recommend taking Acetaminophen 1 gram every six hours (not more than 4 grams in 24 hours), along with mild opioids like Codone / Hydrocodone or Tramadol if available in your area. Codeine 30-60 mg up to six times a day (maximum 240 mg in a day) is another option you could try. Toradol (Ketorolac) is an NSAID (non-steroidal anti inflammatory drug) which can be very effective, but I would not recommend long term use as this can cause gastritis, stomach bleeding, and sometimes kidney problems. You can use it for a few days though, but take them after meals along with stomach acid-reducing medications like Omeprazole, Esomeprazole, etc.

I hope this helps.

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