Pain relief after day surgery

Patient Information Leaflet

 

Introduction

This leaflet is to help you with pain relief after you have day surgery. It gives information on:

• The types of pain relief you can use.
• How you should take them.
• The benefits of good pain relief.
• The risks of pain relief.

Pain after surgery is normal. If pain is left untreated, it may delay your progress so it is important that your pain is controlled.

 

What are the benefits?

Good pain relief can offer many benefits. It can help you rest comfortably and get moving quicker so you can get back to your normal activities.

 

What are the risks?

As with all medication, there can be side effects so it is important you read the manufacturer’s instructions for each of the painkillers you receive. Do not exceed the recommended dose.

 

What painkillers should I use?

After your operation, you will be advised to take one or more of the following painkillers according to the type of operation you have had.

Paracetamol

This is a good general painkiller.

Dose: two 500mg tablets taken every four to six hours.

It gives good pain relief and prevents pain coming on if taken regularly every four to six hours.

The maximum number of tablets you can take in 24 hours is eight tablets.

Ibuprofen

This is a non-steroidal anti-inflammatory drug, which means it reduces both pain and inflammation.

Dose: one 400mg tablet taken every eight hours.

You can take this as well as the paracetamol.

The maximum number of tablets you can take in 24 hours is three tablets.

Ibuprofen should be taken with or after food. Ibuprofen may not be suitable for everyone. If you have ever had problems with severe indigestion or bleeding from the stomach, or you suffer from asthma, seek advice from the staff in the Day Surgery Unit. 

Codeine

This is a stronger painkiller which is helpful against mild to moderate pain.

Dose: one or two 30mg tablets every four to six hours.

It can be taken with paracetamol and/or ibuprofen, if needed.

The maximum number of tablets you can take in 24 hours is eight tablets.

Codeine can cause drowsiness so you should not drive or use machinery while taking it. You should not drink alcohol while you are taking codeine. Constipation is common while taking codeine.

 

Prescription charges for day surgery patients

Patients who have day surgery are not eligible for free prescriptions from the hospital after changes in the law. Therefore, you will need to get paracetamol and/or ibuprofen before you come for your procedure as these will not be issued to you when you leave hospital.

Frequently asked questions

What is the best way to take the tablets?

Effective pain relief is achieved by taking your painkillers regularly rather than waiting until you are in pain.

For mild pain, you could take:

Breakfast: two paracetamol (500mg tablets)

Lunch: two paracetamol (500mg tablets)

Evening meal: two paracetamol (500mg tablets)

Bedtime: two paracetamol (500mg tablets)

And you can add a 400mg ibuprofen tablet at 6am, 2pm and 10pm.

 

If you need more pain relief, add one tablet of codeine:

Breakfast: two paracetamol (500mg tablets) plus one codeine (30mg tablet)

Lunch: two paracetamol (500mg tablets) plus one codeine (30mg tablet)

Evening meal: two paracetamol (500mg tablets) plus one codeine (30mg tablet)

Bedtime: two paracetamol (500mg tablets) plus one codeine (30mg tablet)

In addition to a 400mg ibuprofen tablet at 6am, 2pm and 10pm.

 

If necessary, you can take two tablets of codeine:

Breakfast: two paracetamol (500mg tablets) plus two codeine (30mg tablets)

Lunch: two paracetamol (500mg tablets) plus two codeine (30mg tablets)

Evening meal: two paracetamol (500mg tablets) plus two codeine (30mg tablets)

Bedtime: two paracetamol (500mg tablets) plus two codeine (30mg tablets)

In addition to a 400mg ibuprofen tablet at 6am, 2pm and 10pm

 

Can I take these painkillers with my own medication?

It is okay to take paracetamol, codeine and ibuprofen with each other, as described in this leaflet.

It will usually be okay to take them with your regular medication but we will advise you if this is not the case.

It is important that you do not take any other preparations containing paracetamol that your GP or another doctor has prescribed for you, or that you have bought yourself, while you are taking the paracetamol we have prescribed for you.

It is important that you do not exceed the maximum dose of painkillers. This may cause you to feel sleepy, nauseated, dizzy and light-headed.

 

Which painkillers should I take and for how long?

Take the painkillers you have been prescribed regularly for two to three days. Make sure you take the painkillers at bedtime to help you get a good night’s sleep.

After two to three days, you may then be able to start reducing your painkillers to as and when you need them. If you have been taking codeine, stop this first, then the ibuprofen and finally the paracetamol.

You may find that even if you do not need any painkillers throughout the day, you still need to take them at night to get a good, pain-free night’s sleep. Some people find that they get little pain at night but need to take more painkillers in the daytime to let them get up and about. This is also a perfectly good way to use the painkillers.  Everyone is different.

Some people find that they get better pain relief with codeine rather than ibuprofen. If this is the case, it is okay to take the codeine with the paracetamol and add in the ibuprofen if you need to.

When it comes to how long you need to take the tablets; again, everyone is different. You may be able to stop taking them after a couple of days or you might need them for a week or so. Do what is best for you.

 

Will they make me sleepy?

Codeine can make you feel sleepy. Listen to your body. If it tells you to lie down and sleep things off – do that. Remember that these are strong painkillers. It is not wise to drive while taking codeine after your operation (you may have been advised not to drive after your operation anyway). Drinking alcohol while taking these drugs will also make you feel more sleepy.

 

Do they cause any other problems?

Some people complain of constipation as a side effect of taking codeine. It is important to drink plenty of fluids and eat plenty of fruit and vegetables to reduce the chance of constipation.

If constipation becomes a problem, see your usual pharmacist or doctor who may advise you on the use of laxatives.

 

What happens if I am still in pain?

If your pain breaks through at any time and you cannot control it with the painkillers we have recommended for you, telephone the Day Surgery Unit for advice.

Contact us on 01384 456111 ext. 1886 (7am to 9pm, Monday to Friday).

Out of hours – for urgent queries

Phone Surgical Assessment Unit on 01384 456111 ext. 3359 or contact your GP to speak to the out of hours service or phone 111 for telephone advice.

 

Keep a record

You can use this chart to record the painkillers that you take. This will also make sure that you do not take too many tablets.

Paracetamol = P Ibuprofen = I Codeine = C	Breakfast	Lunch	Evening meal	Bedtime
Day 1
Day 2
Day 3
Day 4

You have been prescribed up to three painkillers to take home:

Paracetamol – 500mg tablets

Ibuprofen – 400mg tablets

Codeine – 30mg tablets

 

When do I start taking my painkillers?

For many day surgery procedures, you will receive pain relief in addition to the anaesthetic either during your procedure, in the recovery area or on the day case ward before you go home. Therefore, your nurse will tell you at what time you can take your first painkillers after you get home.

[Nurse to complete]

Paracetamol ………………….. Day ……………… Time …………………

Ibuprofen ………………………. Day ……………… Time …………………

Codeine ………………………… Day……………  Time………………….

 

Co-codamol preparations

Co-codamol is a combination of paracetamol and codeine phosphate.

• Co-codamol tablets containing 500mg paracetamol with 15mg or 30mg codeine may be prescribed for short-term relief of moderate or severe pain.
• Co-codamol containing 500mg paracetamol with 8mg codeine can be bought without a prescription from pharmacies for short-term (up to three days) relief of acute, mild to moderate pain.

Dose: One or two tablets every four to six hours. The maximum number of tablets you can take in 24 hours is eight tablets.

Co-codamol preparations cannot be taken with any additional paracetamol, or paracetamol containing products.  It is important to check all medicinal products to see if they contain paracetamol, for example, cold and flu remedies. An overdose of paracetamol is dangerous and capable of causing serious damage to the liver.

Co-codamol preparations can be taken with ibuprofen, if needed.

Codeine can cause drowsiness so you should not drive or use machinery while taking it. You should not drink alcohol while you are taking codeine. Constipation is common while taking codeine.

 

What is the best way to take Co-codamol tablets?

Effective pain relief is achieved by taking your painkillers regularly rather than waiting until you are in pain. You can take:

Breakfast: Two Co-codamol

Lunch: Two Co-codamol

Evening meal: Two Co-codamol

Bedtime: Two Co-codamol

In addition to a 400mg ibuprofen tablet at 6am, 2pm and 10pm

It is important that you do not exceed the maximum dose of painkillers. This may cause you to feel sleepy, nauseated, dizzy and light-headed.

 

How long should I take Co-codamol?

Take the painkillers you have been prescribed regularly for two to three days. Make sure you take the painkillers at bedtime to help you get a good night’s sleep. After two to three days, you may then be able to start reducing your painkillers to as and when you need them.

If you have been taking Co-codamol and ibuprofen, stop the ibuprofen first and then the Co-codamol. You may find that even if you do not need any painkillers throughout the day, you still need to take them at night to get a good, pain-free night’s sleep.

Some people find that they get little pain at night but need to take more painkillers in the daytime to let them get up and about. This is also a perfectly good way to use the painkillers.

Everyone is different. Do what is best for you.

 

For further information:

If you have any questions, or if there is anything you do not understand about this leaflet, please contact Day Surgery Unit, Russells Hall Hospital on 01384 456111 ext. 1886 (7am to 9pm, Monday to Friday).

If you have any feedback on this patient information leaflet, please email dgft.patient.information@nhs.net

This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.

Originator: Alison Pyatt-Payne Date reviewed: March 2023 Next review due: August 2026 Version: 3 DGH ref: DGH/PIL/01440