ROJoson PEP Talk: Do all patients need painkillers after an operation?

1. DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?
February 24, 2024
1400H - 1500H
Via Zoom
Empowerment
objective - for
laypeople to have an
essential
understanding of
USE of PAINKILLERS
AFTER AN
OPERATION in their
health management.

2. DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?
Empowerment
objective - for
laypeople to have an
essential
understanding of
USE of PAINKILLERS
AFTER AN
OPERATION in their
health management.
Welcome all!
MUTE yourself but always
show your video picture.
Sign in your name, FB
account, or email address in
the Chat Box! Include names
of companions attending.
Use the Chat Box to ask
questions and make
comments while the PEP TALK
is on.
There will be group pictures
at start and end of PEP TALK –
show your face in video.
February 24, 2024
1400H - 1500H
Via Zoom

3. Reminder after the PEP
Talk:
Take the Online Learning
cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.
Link is in Chat Box.

4. Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation

5. DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?
Empowerment
objective - for
laypeople to have an
essential
understanding of
USE of PAINKILLERS
AFTER AN
OPERATION in their
health management.
ROJOSON’S REQUEST:
FEEDBACK TO THIS
PEP TALK!
Pls. type in your
feedback in the chat
box during the open
forum and before we
adjourn!
Thank you!

6. DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?
Empowerment
objective - for
laypeople to have an
essential
understanding of
USE of PAINKILLERS
AFTER AN
OPERATION in their
health management.
LET’S NOW HAVE A
GROUP PICTURE
TAKING BEFORE WE
START PEP TALK
PROPER IN 2
MINUTES!
Pls. turn on your
video!
Show your face!

7. DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?
Empowerment
objective - for
laypeople to have an
essential
understanding of
USE of PAINKILLERS
AFTER AN
OPERATION in their
health management.
ROJoson PEP Talk
I have a Patient
Empowerment
Program in which I
like to empower the
lay people or
patients to take
control in the
management of
their health.

8. I started the PEP Talk
on May 15, 2021.
There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.

9. From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer depending on
our enthusiasm,
discipline and
perseverance.

10. DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?
Empowerment
objective - for
laypeople to have an
essential
understanding of
USE of PAINKILLERS
AFTER AN
OPERATION in their
health management.
My PEP TALK today is
entitled:
DO ALL PATIENTS
NEED PAINKILLERS
AFTER AN
OPERATION?

11. Contents
• What is an operation?
• What are painkillers?
• What are the uses of painkillers after an
operation?
• Do all patients need painkiller medicines after
an operation?
• What governs the prescription of
postoperative painkiller medicines by the
physicians?
• What governs the intake of postoperative
painkiller medicines by the patients at home?
• What are the basic information on analgesics?
Disclaimer:
ROJoson PEP Talk
contains ROJoson’s
Thoughts,
Perceptions,
Opinions and
Recommendations
(TPORs) culled from
experiences of
ROJoson and other
professionals.
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

12. pera
What is an operation?
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

13. What is an operation?
Operation in this PEP Talk refers to a medical
operation.
“Operation” will used interchangeably with the
word “surgery.”
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

14. What is an operation?
Concept and definition of operation have
evolved.
Before, traditionally, an operation
• is the process of “cutting” open someone's
body in order to repair, replace, or remove a
damaged part.
• uses “instruments.”
• is done by a “surgeon.”
• is done to “treat.”
• Is done in an “operating room.”
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

15. What is an operation?
Concept and definition of operation
have evolved.
Before, traditionally, an operation
• is the process of “cutting” open
someone's body in order to repair,
replace, or remove a damaged part.
• uses “instruments.”
• is done by a “surgeon.”
• is done to “treat.”
• Is done in an “operating room.”
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?
Nowadays, an operation may
consist of
• no cutting
• no instruments; just manual
(hands)
• all medical specialists doing
interventional procedures
• diagnosis
• outside the operating room
such as clinics, nursing floors,
etc.

16. What is an operation?
Concept and definition of operation
have evolved.
Before, traditionally, an operation
• is the process of “cutting” open
someone's body in order to repair,
replace, or remove a damaged part.
• uses “instruments.”
• is done by a “surgeon.”
• is done to “treat.”
• Is done in an “operating room.”
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?
Nowadays, an operation may
consist of
• no cutting
• no instruments; just manual
(hands)
• all medical specialists doing
interventional procedures
• diagnosis
• outside the operating room
such as clinics, nursing floors,
etc.
Thus ….
an operation or surgery is a procedure done on a patient’s
body, either manually or with use of instruments and
equipment; with or without a cut or incision; for diagnosis
or/and treatment.
It can be done by anybody qualified to do the procedure, not
limited to the traditional surgeons. Examples, interventional
radiologists, cardiologists, gastroenterologists, pulmonologists
can do operative or surgical procedures and therefore, may be
loosely called surgeons also.

17. What are painkillers?
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

18. What are painkillers?
Painkillers and pain relievers will be used
interchangeably. Analgesics is a medical term for
painkiller and pain reliever medicines.
Painkillers and pain relievers consist of the use of
chemical substances (such as drugs and herbs)
and non-use of chemical substances (e.g. warm
and cold compress; exercise; ultrasound;
operative procedure; radiation) to kill or lessen
the pain that is or may be present, such as after
an operative or surgical procedure.
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

19. What are the uses of painkillers after an
operation?
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

20. What are the uses of painkillers after an
operation?
Traditionally, when an operative or surgical
procedure is performed, the belief is that it is
always accompanied by pain after the procedure.
Thus, traditionally, painkillers or pain relievers
are prescribed to patients after an operative or
surgical procedure.
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?
The question is:
With the current
concept of an
operation or surgery,
do all patients need
painkillers after an
operation?

21. Do all patients need painkiller medicines after an
operation?
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

22. Do all patients need painkiller medicines after an
operation?
ANSWER: NOT ALL
NOT ALL PATIENTS NEED TO TAKE PAINKILLER
MEDICINES AFTER AN OPERATION.
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

23. Do all patients need painkiller medicines after an operation?
ANSWER: NOT ALL
THERE ARE OPERATIVE PROCEDURES THAT ARE NOT ASSOCIATED WITH
PAIN.
EXAMPLES:
• THOSE THAT DO NOT INVOLVE A CUT OR INCISION ON THE SKIN.
• THOSE THAT DO NOT INVOLVE A CUT OR INCISION ON THE MUCOSA
OF THE MOUTH, THROAT, ESOPHAGUS, STOMACH AND
ANORECTUM. Note: cuts on mucosa of small and large intestines
are usually not associated with pain.
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?
Example: GIT ENDOSCOPY –
usually no cut – no pain

24. Do all patients need painkiller medicines after an
operation?
ALL OPERATIVE PROCEDURES THAT ARE
ASSOCIATED WITH A CUT ON THE SKIN AND
MUCOSA (ON THE AREAS SPECIFIED ABOVE)
SHOULD BE ASSUMED TO BE ACCOMPANIED BY
POSTOPERATIVE PAIN AND
PAINKILLER MEDICINES SHOULD BE PRESCRIBED.
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?
NO painkiller medicines
will be needed after a
short-painful procedure
but there is no pain soon
after the procedure.
Example:
Needle aspiration – pain
during the aspiration.
A few minutes after the
aspiration, pain subsided
or became tolerable. NO
need for painkiller
medications.

25. What governs the prescription of postoperative
painkiller medicines by the physicians?
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

26. What governs the prescription of postoperative
painkiller medicines by the physicians?
Postoperative painkiller medicines are prescribed
by physicians guided by the following:
• Usual degree of pain after the procedure
• Pain threshold of the patient
• Whether patient can take oral painkillers or
not
• Effectiveness – risks / side effects – cost –
availability of the painkiller medicines
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?
Analgesics:
Mild - milder –
stronger - strongest
Route: Oral – non-
oral
BRCA: most cost-
effective possible

27. What governs the intake of postoperative
painkiller medicines by the patients at home?
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

28. What governs the intake of postoperative painkiller medicines by the
patients at home?
Communicate with attending physician who did the procedure
regarding the following:
• Usual degree of pain after the procedure
• Whether oral painkillers can be taken or not
• Effectiveness – risks / side effects – cost – availability of the
painkiller medicines
Follow advice of physicians but ask all the questions needed for a
cost-effective pain control at home.
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

29. a
What governs the intake of postoperative painkiller medicines by the
patients at home?
What to do at home:
• Continuously monitor the degree of pain, by the hour, until pain has
disappeared or at least tolerable, in terms of mild – moderate –
severe or pain score from 0 to 10 (report to physician as advised or
needed).
• With the physician’s help, have two categories of painkiller medicines
at home (one stronger, one milder). May shift to milder analgesics if
pain has decreased but painkiller medicine is still needed based on
self-assessment.
• If pain is mild and tolerable already, discontinue painkiller medicines.
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

30. What are the basic information on analgesics?
Analgesics, also called painkillers or pain
relievers, are medications that relieve different
types of pain.
Analgesics can be in oral form or non-oral form
(injectable / patch).
Some analgesics can be bought over the counter,
others require a prescription.
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

31. What are the basic information on analgesics?
What are analgesics used for?
Analgesics are used to relieve pain and inflammation. For example:
• After surgery.
• Due to injury, such as a fractured bone.
• For acute (sudden, short-term) pain, such as a twisted ankle
or headache.
• For aches and pains like menstrual cramps or muscle soreness.
• For chronic painful conditions such as arthritis, cancer or back pain.
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

32. What are the basic information on analgesics?
What are the groups or classes of analgesics?
• Paracetamol
• Anti-inflammatory analgesics (NSAIDs – non-steroidal anti-
inflammatory drugs)
• Opioids
• Paracetamol – not anti-inflammatory, but reduces pain signals to brain
• Anti-inflammatory analgesics – reduce inflammation
• Opioids – change the brain’s perception of pain
*Compound analgesics – combination of several active ingredients
(examples: paracetamol + NSAID; paracetamol + opioid)
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

33. What are the basic information on analgesics?
What are examples of the different classes of
analgesics?
• Paracetamol
• NSAIDs – ibuprofen, naproxen, mefenamic
acid
• Opioids – tramadol, codeine, morphine,
fentanyl
• Compound analgesics – paracetamol + NSAID;
paracetamol + opioid; NSAIDs + opioid)
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

34. What are the basic information on analgesics?
What are the indications for the different classes
of analgesics?
• Paracetamol – first-line (effective for mild-
moderate pain and safest)
• NSAIDs – second-line (effective against mild-
moderate pain and in those with
inflammation)
• Opioids – effective against severe pain
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

35. DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?
Summary
Take Away
Contents
• What is an operation?
• What are painkillers?
• What are the uses of painkillers after an
operation?
• Do all patients need painkiller medicines after
an operation?
• What governs the prescription of
postoperative painkiller medicines by the
physicians?
• What governs the intake of postoperative
painkiller medicines by the patients at home?
• What are the basic information on analgesics?

36. Be always in touch with reliable medical
information on USE OF PAINKILLERS AFTER
AN OPERATION.
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions /
make better decisions on USE OF
PAINKILLERS AFTER AN OPERATION in your
health management.
Take Away in
relation to
Patient
Empowerment
DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?

37. DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?
Empowerment
objective - for
laypeople to have an
essential
understanding of
USE of PAINKILLERS
AFTER AN
OPERATION in their
health management.

38. Reminder after the PEP
Talk:
Take the Online Learning
cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.
Link is in Chat Box.

39. Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation

40. DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?
Empowerment
objective - for
laypeople to have an
essential
understanding of
USE of PAINKILLERS
AFTER AN
OPERATION in their
health management.
ROJOSON’S REQUEST:
FEEDBACK TO THIS
PEP TALK!
Pls. type in your
feedback in the chat
box during the open
forum and before we
adjourn!
Thank you!

41. DO ALL
PATIENTS
NEED
PAINKILLERS
AFTER AN
OPERATION?
Empowerment
objective - for
laypeople to have an
essential
understanding of
USE of PAINKILLERS
AFTER AN
OPERATION in their
health management.
LET’S NOW HAVE A
GROUP PICTURE
TAKING BEFORE WE
START Q&A AND
INTERACTIONS!
Pls. turn on your
video!
Show your face!