Pain medications after surgery may include opioids, anesthetics, nonsteroidal anti-inflammatory drugs (NSAIDs), and other types of medications.

Taking pain medications after surgery can help people manage pain and inflammation. It may also help improve recovery and reduce the risk of complications.

This article looks at the types of pain medication people may use after surgery and the possible side effects.

A healthcare professional wearing a mask -2Share on Pinterest
Westend61/Getty Images

Pain medications after surgery may include:

Drug typeExamplesHow they work
opioids• hydrocodone (Vicodin)

oxycodone (OxyContin or Percocet)

• morphine (Kadian or Avinza)

• codeine

• oxymorphone (Opana)

fentanyl (Sublimaze)

• tramadol

• methodone (Dolophine)
Opioids bind to receptors on the cells in the brain, the spinal cord, and other organs. They block the transmission of pain signals to the brain.

Tramadol and fentanyl are synthetic opioids, and oxymorphone is a semisynthetic opioid. This means manufacturers make these drugs fully or partially from human-made chemicals instead of from the opium poppy.
anestheticsLocal anesthetics include:

• lidocaine (Xylocain or Lidoject)

• bupivacaine (Exparel)

• ropivacaine (Naropin)
Local anesthetics block pain signals that travel along the nerves. They can ease pain in a small area of the body.

Regional anesthetics provide pain relief in larger areas of the body.
NSAIDsibuprofen (Advil)

naproxen sodium (Aleve)

• celecoxib (Celebrex)

• ketorolac (Toradol)

NSAIDs can help relieve pain and reduce inflammation.

They block an enzyme called cyclooxygenase, which makes prostaglandins.

Prostaglandins have associations with the body’s inflammation response to injury.
psychoactive drugs• midazolam (Versed)

gabapentin (Horizant, Gralise, or Neurontin)

pregabalin (Lyrica)

• ziconotide (Prialt)
Psychoactive drugs affect a person’s mental function, including perception. They can help relieve nerve pain.
other• acetaminophen

ketamine (ketalar)
Acetaminophen blocks the production of prostaglandins.

Ketamine blocks the signaling pathway of some cells that have an association with pain.

Opioids are effective pain relievers for moderate or severe pain. They contain chemicals that can relieve pain and relax the body.

People may take opioids:

  • intravenously
  • orally as a pill or liquid
  • as a suppository

A doctor may prescribe the following opioids:

  • hydrocodone (Vicodin)
  • oxycodone (OxyContin or Percocet)
  • morphine (Kadian or Avinza)
  • codeine
  • fentanyl
  • oxymorphone (Opana)
  • methodone (Dolophine)

Doctors may also prescribe tramadol.

Although tramadol is a synthetic opioid, it works differently than other opioids. It is most effective when a person takes it alongside NSAIDs or acetaminophen.

Side effects, risks, and considerations

Possible side effects of opioids include:

  • nausea
  • vomiting
  • constipation
  • increased sensitivity to pain
  • dry mouth
  • confusion
  • dizziness
  • drowsiness or sleepiness
  • itching
  • sweating
  • depression

The Centers for Disease Control and Prevention (CDC) note that although opioids are an important part of a person’s treatment, they carry a serious risk of addiction and overdose.

The National Institute on Drug Abuse states that opioids are generally safe to take for a short time while following a doctor’s recommendation.

High doses of opioids may slow breathing and can be fatal. Combining opioids with alcohol or certain drugs, including benzodiazepines and sleep aids, increases the risk of overdose and death.

NSAIDs help reduce inflammation and swelling and relieve mild pain. Doctors may combine NSAIDs with opioids after surgery to manage moderate or severe pain.

Examples of NSAIDs include:

  • ibuprofen
  • naproxen sodium
  • celecoxib
  • ketorolac
  • aspirin

People may take NSAIDs in the form of:

  • pills or capsules
  • a topical gel or solution
  • intravenous infusion
  • a suppository

Side effects, risks, and considerations

Side effects of NSAIDs may include:

NSAIDs may reduce the need for opioids and do not lead to dependency. However, they do not relieve severe pain on their own.

Doctors may prescribe acetaminophen alongside opioids to increase the absorption of opioids and relieve moderate to severe pain.

Acetaminophen raises the body’s pain threshold and lowers high body temperatures.

Side effects

Side effects of acetaminophen may include:

  • skin rash
  • nausea
  • vomiting
  • constipation
  • itching
  • abdominal pain
  • kidney damage
  • blood disorders

Long-term use or high doses of acetaminophen may cause liver damage.

Local anesthetics block pain in a specific area of the body. People may receive a local anesthetic as an injection, through a tube into the wound or nerves around the surgery site, or into the epidural space.

Local anesthetics include:

  • lidocaine
  • bupivacaine
  • ropivacaine

A doctor may also administer regional anesthetics. These numb the nerves and may work for several hours after surgery to block pain in a larger area, such as the lower body, arm, or leg. People may feel numbness in this area.

To administer regional anesthetics, a doctor may give a person an injection or insert a needle or catheter to deliver medication to the affected area.

Side effects, risks, and considerations

Side effects and risks of local anesthetics may include:

  • allergic reaction to the anesthetic
  • nerve damage
  • muscle spasms
  • convulsions

Side effects and risks of regional anesthetics may include:

  • headache
  • allergic reaction to the anesthetic
  • nerve damage
  • a collapsed lung during an injection in the chest area, in rare cases

People may also take psychoactive drugs, or psychotropics. These drugs affect mental function, including perception, mood, emotions, and consciousness.

Psychoactive drugs may help relieve nerve pain.

Psychoactive drugs for pain relief include:

People may receive psychoactive medication through an injection or take it orally as a pill.

Side effects, risks, and considerations

Possible side effects of psychoactive drugs include:

  • change in appetite
  • thirst
  • headaches
  • movement changes

For pain management, doctors may prescribe low doses of ketamine either alone or alongside other pain-relieving medications.

Ketamine is a safe and effective means of pain relief when a person takes it alongside injectable NSAIDs and opioids.

Side effects, risks, and considerations

The most common side effects are:

  • nausea
  • vomiting
  • dizziness
  • drowsiness
  • diplopia, or double vision
  • dysphoria
  • confusion

To reduce the risks of using opioids, the CDC recommends:

  • avoiding sharing any prescription medication with others
  • taking opioids only as a doctor instructs and at the correct dosage
  • storing opioids in a safe and secure place, ideally a locked drawer or cabinet, to stop other people from reaching them
  • disposing of any expired or unused opioids right away by using a take-back service or returning them to the pharmacy

After major surgery, people may stay in the hospital for pain management and monitoring.

For the first few hours or days after surgery, people may receive IV pain medication.

People may also have patient-controlled analgesia, which allows them to press a button to administer IV medication through a pump when they need it. However, healthcare professionals can limit the dosage.

After minor surgery, people may be able to manage their pain at home. They may use prescription or over-the-counter pain medication, depending on the severity of their pain.

A doctor may also advise other methods for managing pain, such as ice, heating pads, or relaxation techniques to help reduce pain and inflammation.

The type of pain medication a person may use after surgery depends on the extent of surgery and the severity of the pain.

People can let their healthcare team know about any medications, supplements, or herbal remedies they have been taking, as well as any history of substance misuse or addiction. This can help healthcare professionals minimize potential side effects and risks.

It is important that people let a doctor know if they are in pain or experiencing any side effects from medications.