Post op pain in opiod patients out patient

Patient : I am a chronic pain patient on 100mg. Of morphine t.i.d ( s.r.) and 30 mg. I.r. I'm having out patient surgery on my left arm. I was concerned about being opiod tolerant and the post op pain. My surgeon said he'd give me something above and beyond my current pain meds for the post op pain. Isn't Morphine the top of the line. Kenneth Mckenna
Doctor :   Thank you for your question. Given that you are on significant doses of morphine, it may be a good idea to meet wit h your pain specialist or an anesthesiologist who does acute pain management. You should definitely continue with your long acting medications, but may need an increased dose of immediate release. Also, it would be important to consider multimodal pain control by using medications like gabapentin, acetaminophen and Celebrex to augment your regime. In my opinion, you should speak to the doctor who prescribes your pain medications and also, ask your surgeon to arrange a pre-op consultation with anesthesia to discuss. For surgery on the arm, they may also wish to do a regional anesthetic block to put the arm to sleep. This significantly decreases post operative pain and your medication requirements. Good luck with your surgery.

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