Can a woman manage Spigelian hernia postoperative pain at 52?

Question

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 childbirth 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?

Please advise.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your apprehension about the pain.

Spigelian hernia (a condition where when the organs bulge between the front abdominal muscles) 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 (a technique that delivers an anesthetic into the epidural space) for pain relief.

The anesthetist in charge should be able to manage his drug repertoire, opioid resistance (reduced responsiveness to an opioid agonist such as Morphine) is very unusual, and in our experience, it is usually due to inadequate dosing. I would also recommend IV Paracetamol (Acetaminophen) in the postoperative period if that is available in your center.

In the later postoperative 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 to 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) that 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.

Please let me know if you want some help.

Thank you.