With a
little extra care and consideration, it is usually possible to avoid most of the
postoperative pain that so many people are afraid of. I am often surprised
at some doctors' lack of attention to this detail that is so small and yet so
important!
Avoiding postoperative pain begins during the operative procedure itself. One of the ways to minimize the effects of anesthesia and decrease the possibility of nausea, is to create a situation where the anesthesiologist can use less medicine while the patient is equally comfortable. While you do not have to do local anesthesia if an anesthesiologist is giving intravenous anesthesia, if you do use local in addition, the anesthesiologist can use much less systemic anesthesia.
There are many choices for local anesthesia today. 
In most of my surgeries I include a local anesthetic called Marcaine. This
local anesthetic can last as long as 12 to 14 hours. When this is done, a
patient usually wakes up more quickly and quite comfortably.
The next trick involves how we prescribe pain medication.
It has been my experience, that if we wait for pain to take pain pills it is way too late! It can take quite some time to develop an adequate blood level of pain medication when taking pills. In most cases then, telling somebody to take pills for pain will condemn them to a period of suffering until these pills take effect. In most hospitals doing major surgery, pain medicine is given by a pain pump which continually gives the patient low levels of pain medicine. This keeps an adequate blood level in the postoperative period. I believe that a modification of this is the best way to manage postoperative pain at home.
As mentioned above, I give long-acting local anesthesia during almost all of my surgeries and have my patients take their pain pills every three hours starting in the recovery room whether they have pain or not. By the time the local anesthesia wears off, patients have had three or four doses of pain medicine and therefore have an adequate blood level. By adhering to this schedule, the vast majority of patients can avoid significant postoperative pain and many report no pain at all!
