In thoracic surgery, thoracoscopy is currently one of the most widely used surgical methods. The biggest advantage of thoracoscopy is that the surgical trauma is minimal, but the pain will not disappear. Moreover, postoperative pain in thoracic surgery is particularly significant among all surgical procedures. So, let's take a look at the postoperative pain together!
1、 The sources of postoperative pain:
1. Surgical incision
Due to the presence of branches of thoracic and intercostal nerves in the intercostal space, surgical incisions inevitably cause more or less damage. However, compared to traditional methods, there is no need for rib expanders to expand the incision or cut the ribs, resulting in a significant reduction in damage to the thoracic and intercostal nerves.
2. contusion or traction of surrounding tissues or nerves
During the surgical process, doctors need to use and replace various instruments such as suction devices, ultrasonic knives, cutting and suturing devices, and double joint forceps back and forth through the incision. As the surgery progresses, the entry and exit of instruments and the change of operating angles must be completed within a narrow incision, inevitably causing contusion and traction of surrounding tissues and nerves. This is also a fact that endoscopic surgery cannot avoid at present.
3. Placement of Postoperative Drainage Tubes
After thoracic surgery, most patients require 1-2 drainage tubes to be placed in order to remove the accumulated air or exudate in the chest cavity, maintain negative pressure in the chest cavity, and promote sufficient expansion of healthy lung lobes after surgery. However, due to the early postoperative period, the intercostal nerves and chest wall nerves are in a edematous phase, and the contraction of chest wall muscles during breathing, the presence of the chest tube makes the pain at the incision site more pronounced.
4. Musculoskeletal pain and involvement pain
In some postoperative patients' feedback, some people may say that they have shoulder pain. There are two reasons for this situation. One is that the upper limb stays out for a long time during the surgery, causing stiffness in the shoulder muscles and joints; The second reason is that the phrenic nerve, which belongs to the diaphragm, intersects with the supraclavicular nerve and originates from the C3 spinal nerve. Therefore, when the diaphragm is stimulated during surgery, there will be referred pain in the shoulder.
2、 What methods can alleviate pain?
1. Take painkillers on time and maintain a good attitude.
Take painkillers on time according to medical advice and get enough sleep, which is more conducive to your ability to cope with pain and promote recovery. Relax your mind by reading and listening to light music to relieve pain, shift your focus, and avoid self suggestion that the pain will worsen.
2. Find a comfortable position
When the pain is intense, you can change to find the most comfortable position appropriately, which can alleviate some pain to a certain extent, maintain an optimistic and upward attitude, and adopt the chest strap external fixation method to limit the range of chest movement when the patient coughs. Believe that you can definitely overcome the disease.
3. Learn to describe your own pain
According to the NRS numerical scoring system, 0 points represent no pain at all, and 10 points represent the most severe pain. You can score based on your immediate feelings and inform the medical staff so that we can take appropriate pain management measures for you.
4. Reasonable use of analgesics
Currently, our ward adopts multimodal combined analgesia. By combining analgesic drugs or methods with different mechanisms of action, the dosage of each drug is reduced, and the side effects are correspondingly reduced. The analgesic effects are added or coordinated to achieve the maximum effect/side effect ratio. Take painkillers on time and in the prescribed amount under the guidance of a doctor. The combination of different analgesic techniques or mechanisms of action of analgesics, acting on different targets of pain transmission pathways, exerting additive or synergistic analgesic effects, can reduce the dosage of each drug and correspondingly alleviate side effects. This method is called multimodal analgesia.
5. Psychological and spiritual support for family members
Patient family members should objectively view the patient's pain and assist medical staff in making nursing treatment plans. They should accurately and timely administer painkillers, observe their effects and adverse effects, and inform medical staff. They should give more encouragement and comfort to patients, so that they do not give up easily and have more courage to face it. They should encourage patients to enhance their confidence and overcome this hurdle.
In short, every patient has the right to be exempt from pain. We hope everyone can fully understand pain, and encourage everyone to bravely speak out about it. After all, the most important way to overcome pain is to face it directly! Finally, I hope all patients can stay away from pain and recover soon!