The Art of Taking Pain Medications by a Recovery Room Nurse
So, you’re taking pain medication and still can’t get your pain under control? Let’s talk about it.
Your doctor prescribed ‘oxycodone 5mg every 6 hours.’ You have taken your first dose at 12p and think to yourself ‘I really don’t like taking pain meds, I’m gonna stretch my next dose pass the 6 hours until I start feeling pain again, maybe until 8p.’ 6 hrs have passed and you start to feel a mild amount of pain, you say ‘I knew I’d be alright, the healthcare system just wants us hooked on meds.’ You’re now approaching the 8 hour mark and the pain has become moderate. You are visibly uncomfortable and take your next dose. By 9p you are now too uncomfortable to fall asleep and you’re wondering about increasing your dose or worse ‘this medication does nothing for me.’
Let’s Address Some Errors in Your Approach
5mg oxycodone is what I call a small but mighty dose. The formulation of this opioid is effective enough to be given in the recovery room after a knee replacement surgery so it should be sufficient enough to manage most pain at home. It is the approach to stretch the next pain medication dose outside of the prescribed hours that puts you at risk for insufficient pain management. Consideration for how long your body takes to process the medication for pain relief, the peak effect of the medication and how long the medication takes to be eliminated from your body are a key considerations of pain management.
A Better Approach
On average, oral pain medications take about 30 mins for you to start feeling beneficial pain relief. The peak effect (meaning when the medication starts giving its maximum pain relief) is roughly 30-60mins. The oxycodone pain relief effects will last about 3-6 hours, depending on a few factors like pain level. With a little math, you’ll see that the mindset to wait a full 8 hours before your next pain medication dose leaves your system without any pain fighting for quite some time.
So from the scenario above, your doctor prescribed ‘oxycodone 5mg every 6 hours.’
You have taken your first dose at 12p and next dose at 8p
The oxycodone would have left your system by the 6 hour mark leaving you without any pain control for 2 hours
Add 30 mins more for the next pain medication dose to actually start helping
Then another 30mins for the dose to reach its peak
In this case, you have been without sufficient pain control for 3 hours, your nervous system is stressed and now this pain level may actually need more than 5mg oxycodone to regain comfort. With pain management, we never want our body completely without medication prior to the next dose. At that point you’ll be stuck playing catch up with a dose that now really may be too small for that increased, isolated pain level.
A Nurse’s Opinion
This mismanagement of pain medication happens more often than not. Prior to becoming a nurse, this prolonged dosing was my mindset. With years of schooling and practice this is the approach nurses take in the hospitals to provide maximum pain relief to our patients. I’d recommend using this framework yourself. All medication onset, peaks and duration are available from reputable sources online.
I hope this has been helpful. Please let me know if you’ve learnt anything. Be well. <3
KAM Health
By Kerri-Ann Villanueva, BSN, BSC, RN
Founder & Administrator | Nurse-led health education & recovery insights
KAM Health educational products are intended to provide general educational information. Guides, workbooks, journals, and other educational materials are not intended to replace individualized medical evaluation, diagnosis, treatment, or instructions from a qualified healthcare professional. Information contained in a KAM Health publication does not create a nurse-patient relationship by itself. If you are experiencing a medical emergency, seek emergency medical attention immediately.
