Post-Surgical Pain Case Studies

Pain is defined as “whatever the experiencing person says it is, existing whenever he or she says it does” (173). With the information provided in the scenario of Mr. Clark and Mrs. Wong, this writer believes Mr. Clark is experiencing the greatest amount of post-operative pain. The numerical pain rating scale provides supporting data due to Mr. Clark rating his pain as 8/10 and Mrs. Wong as 3/10. In addition to the numerical pain scale, a focused interview should be conducted. A focused interview will provide much needed, additional information as to the onset, location, duration, and characteristics of the pain and the patient can receive proper treatment in return (181).

Pain is individualized and no two people will experience or measure
pain the same, not even when the same surgical procedure is performed. Possible variations can be explained by preoperative teaching, cultural differences, or possibly related to previous experiences with pain. Preoperative teaching must be individualized to the patients’ needs and educational level. Research shows when a patient understands what to expect post operatively, they are often able to cope better with post-operative pain (surgery encycl). An integral part of patient teaching is awareness of a patient’s cultural heritage and ethnicity background. Both are recognized as influencing a person’s reaction to pain as well as their expression to pain (177). One culture may be expressive about pain, and an individual from a different culture may keep those feelings to themselves and not bother others (177). An example, is the scenario of Mr. Clark and Mrs. Wong. Mr. Clark is Anglo Saxon which is more verbal when expressing pain. Mrs. Wong on the other hand is Chinese which often tends to be more stoic (book). Finally, a patient may experience a different level of pain post operatively due to previous experiences. A previous, negative experience with uncontrolled pain will affect the way an individual responds to pain (173).

Many factors can affect a patient’s pain, but complications should not be overlooked when a patient is experiencing post-surgical pain.
A post-surgical complication known as neurovascular compromise is no exception to the rule. Neurovascular compromise is defined as impairment to the nerves or blood supply to any area (Merriam). When the blood supply is impaired, the patient will experience pain, which is disproportionate to the injury or surgical procedure and unrelieved by opioid analgesia (rch). Orthopedic surgery such as hip arthroplasty increases a patients risk for neurovascular compromise due to the complex nerve and vascular system which encompasses the hip structure. Nursing professionals should provide neurovascular checks every hour for the first 24 hours post injury, surgery, or cast placement, then every 4 hours for the next 48 hours (rch). Assessment should be increased in frequency if the patient’s status deviates from initial baseline. Proper assessment should include sensation, motor function, color, temperature, capillary refill, swelling, and pulses of the affected extremity. Without proper assessment, early recognition, and prompt treatment, the patient could experience permanent deficits, loss of the affected limb, or even death
(rch).
(rch.org)
http://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Neurovascular_observations/

WebMD defines alternative therapy as any kind of medical treatment or intervention used in place of conventional medicine. An alternative therapy known as transcendental meditation is growing in popularity due to its openness to all ages, cultures, and life styles, as well as added health benefits (ibtimes). Transcendental meditation is defined as a simple, natural, and effortless technique where the individual sits quietly in a comfortable position; eyes closed, and silently repeats a Vedic mantra of India. A mantra is a meaningless sound from the Vedic tradition. Transcendental meditation is recommended twice daily for twenty minutes (TM). During this twenty minutes, the meditators mind is to settle inward and focus on quieter levels of thought until the most silent and peaceful level of awareness is experienced, which is known as pure consciousness™. During the pure consciousness state, the meditator experiences perfect stillness, rest, stability, order, and a complete absence of mental boundaries (WebMD). Studies have proven a reduction in chronic pain, anxiety, high blood pressure, and cholesterol by utilizing the transcendental meditation on a regular basis (WMD). http://www.webmd.com/balance/guide/transcendental-meditation-benefits-technique http://www.ibtimes.com/transcendental-meditation-5-things-know-about-oprahs-new-spiritual-practice-429966

Alternative or complementary methods for pain control are on the rise in healthcare settings today.
The intended goals are to promote wellness in patients. An alternative method known as Reiki is a Japanese technique which promotes the body’s natural healing abilities through stress reduction and relaxation techniques (Holistic hlth). The healing process is carried out by a Reiki practitioner. The practitioner transfers energy to the patient by an actual laying on of hands (reikiorg). The healer restores the patient’s body physically and mentally (everyday). The Reiki technique is based on the idea that unseen life force energy flows through us and is the reason for our existence. When the life force energy is low is when individuals are most likely to be sick or stressed but if high then the individual is more likely to be healthy and happy (reiki.org). During a Rekik session, the healer attempts to unlock the energy channels to allow the patient to have a high life force. In return the patient feels more relaxed, has a less muscle tension and in return experiences less pain. Although Reiki is a simple and easy to use technique it is associated with spirituality which conflicts with the Catholic
beliefs(reiki). http://www.everydayhealth.com/pain-management/can-reiki-help-your-chronic-pain.aspx https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4034623/
http://www.reiki.org/faq/whatisreiki.html