The Treatment of Post-Operative Pain after a Bowel Resection - Research Paper Example

Running head:  BENEFITS OF USING EPIDURALS IN THE TREATMENT OF POST-OPERATIVE PAIN AFTER A BOWEL RESECTION Insert         Insert Grade Insert Tutor’s Name 26 January 2012  Outline Introduction Literature review Additional treatments Conclusion Benefits of Using Epidurals in the Treatment of Post-Operative Pain After a Bowel Resection Introduction Post-operative pain treatment aims at providing comfort to the patient, hence enabling the patient to breathe or move easily. This is because unrelieved pain after surgery is very uncomfortable and unhealthy (virtual anesthesia textbook, 2011). As a result, postoperative pain treatment reduces postoperative complications such as impaired wound healing. Epidurals is one such treatment, which provides pain relief; it involves the use of injection and drugs via a catheter in the upper or lower back, causing loss of sensation and numbness in the region where surgery was performed (Reading Anesthesia Associates, 2009). This paper will analyze the benefits of epidurals in treating post-operative pain after bowel resurrection; additional methods will also be discussed that assist in pain management after this operation. Literature Review Effective administration of post-operative pain treatment is beneficial for a patient, as it does not only relieve pain, but also hastens recovery and discharge from the hospital. According to Andres, et al (N.d, p.5), post-operative pain is associated with physical and emotional suffering, as a result, sleeping becomes an impossible mission, and the recovery process is delayed. Therefore, pain management treatments are administered with an aim of improving the quality of a patient’s life, allowing quick recovery, and reducing death cases. Epidural involves the continuous flow of pain relief medicines through a cannula that is placed in the back of a patient. Bowel resection is a surgical procedure whereby, part of large or small intestine is removed; however, it occurs in two forms - large bowel resection or small bowel resection. Large bowel resection involves the removal of part of the large intestines, whilst small bowel resection involves the removal of part of the small intestine that is affected (University of Maryland, Medical Centre, 2011). The advantage of using epidural after bowel resection is that it not only reduces pain, but also prevents post-operative ileus. Patients who undergo bowel resection often experience post-operative ileus, a complication that may arise after a bowel section. In addition, thoracic epidural hastens the recovery of a patient by enabling the bowel to function (Johnson & Walsh, 2009). Holte & Kehlet (2001) argue that, epidural techniques such as anesthetic reduce surgical stress responses, autonomic reflex responses, and organ dysfunctions; they also reduce post-operative morbidity as well. As opposed to inflammatory drugs, which affect the healing of a wound, causing delays in bowel healing, epidural treatment hastens the recovery of a patient (Eipe & Penning, 2009). In the United States alone, over 350,000 patients undergo bowel resection yearly; therefore, the need to reduce surgical complication and increase patients’ comfort is necessary. Opiods are the most famous in post-operative pain control, which are used in epidural techniques. Here, opiods administered are less, hence avoiding complications; the patient’s respiratory system performs much better such that, he is able to breath or cough. As a result, the patient recovers fast, experiences less pain, and less respiratory or cardiovascular complications. Surprisingly, epidural stands out among the rest, since it curbs post-operative pain as well as post-operative ileus. Nevertheless, an epidural technique such as epidural analgesia is associated with some risks. For instance, pain control may be impossible to achieve in some scenarios, and as a result, a patient may develop nausea, drowsiness, or vomiting. In rare cases, numbness may occur; however, the symptom disappears after medication is administered (Cleveland clinic foundation, 2009). Additional treatments Bowel resection is accompanied by severe post-operative pain and a possibility of postoperative ileus. Therefore, there is need for numerous treatments as options to these medical uncertainties. Several treatments exist apart from epidural techniques as a pain control treatment, after bowel resection. They include patient–controlled analgesia, non-steroidal anti-flamatory drugs, and wound pumps among others. According to Counihan & Favuzza (2009), anesthesia technique is effective for reducing pot-operative stress, while neuraxial blockade reduces mortality and surgical stress response as well. Postoperative pain can be unbearable; traditionally, patients who underwent bowel resection were given narcotics that acted as pain relievers. However, today, several pain management treatments are evident, with thoracic epidural being common. Nevertheless, patient-controlled analgesia is an alternative treatment, especially for patients who may be biased towards epidural catheters. IV narcotics are delivered through patient controlled analgesia devices (PCA); this kind of treatment focuses on pain and ileus reduction, and as a result, effective pain control has been achieved through PCA (Counihan & Favuzza, 2009). Nonsteriodal anti-inflammatory drugs are also used for post-operative pain reduction. The use of Ketorolac reduces narcotic requirement and hasten bowel function, another mode of treatment that dose not require drug intake is through wound pumps. This technique involves direct infusion of anesthetic into the operated wound (Counihan & Favuzza, 2009). However, this method is out-dated; nevertheless, it can be used in area where epidural catheters are rare. Pain control is vital after any surgery in order to achieve effective pain control; opioid analgesics and non-opioid can provide a successful pain control process. According to Counihan & Favuzza (2009), these drugs may include an injection of ketorolac or oral consumption of narcotics, and as a result, pain control is achieved. Needless to say, epidural analgesia is considered more effective that administering intravenous medication. As a result, patients who receive this kind of treatment experience less pain when breathing, walking, or coughing, and therefore stand a higher chance of fast recovery. In addition, epidural analgesia reduces the risk of additional complications, such as pneumonia and heart attacks. Needless to say, thoracic epidural analgesia and patient-controlled analgesia provide superior pain control, and contribute to the return of bowel function after bowel resection. Therefore, a physician should advice a patient on the mot effective post-operative pain treatment, depending on his condition. Conclusion Epidural analgesia is a common technique for reducing pain in patients after bowel resection. Patients are guaranteed fast recovery, and they breathe, walk, and cough easily with minimum pain. Nevertheless, it is associated with some risks like any other treatment, whereby, in some cases, pain is not fully controlled, and drowsiness, itching, and vomiting may be evident. However, some patients prefer epidural techniques rather that oral medication or nerve blocks. This is why there is a variety of pain management treatment because some treatments may be effective in some patients and not effective to others. However, pain control should be achieved for all patients; indeed, pain causes restlessness, lack of sleep and physical disturbance, hence slowing down the rate of recovery. Effective pain management techniques should be in place especially in the health care sector, as a result, guaranteeing the comfort of a patient, especially after surgery. Epidural analgesia and patient–controlled analgesia are effective in reducing pain and fostering bowel function. References Andres, J. et al. (N.d). Post-operative pain management good clinical practice. European society of regional anesthesia and pain therapy. Retrieved from http://www.esraeurope.org/PostoperativePainManagement.pdf Counihan, T. & Favuzza, J. (2009). Fast Track Colorectal Surgery. Pub med central journal. Clinics of colonal and rectal surgery. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780234/ Eipe, N & Penning, J. (2009). Bowel Surgery and Multimodal Analgesia: Same Game, New Team? Retrieved from http://www.anesthesia-analgesia.org/content/109/5/1703.full Kehlet, H & Holte, K. (2001). Effect of postoperative analgesia on surgical outcome. Oxford journal. Retrieved from http://bja.oxfordjournals.org/content/87/1/62.full Johnson, M & Walsh, M. (2009). Current therapies to shorten postoperative ileus. Cleveland clinic journal of medicine. Retrieved from http://www.ccjm.org/content/76/11/641.full Reading Anesthesia Associates. (2009). post –operative pain control. Retrieved from http://readinganesthesia.com/postoppain.htm The Cleveland clinic foundation. (2009). Treatment and procedures. Retrieved from http://my.clevelandclinic.org/services/pain_management/hic_pain_control_after_surgery.aspx The Virtual Anesthesia Textbook. (2011). Post-operative Pain. Retrieved from http://www.virtual-anaesthesia-textbook.com/vat/pain.html University of Maryland, medical centre. (2011). Large bowel resection. Retrieved from http://www.umm.edu/ency/article/002941.htm Read More