In America, post-op hysterectomy patients are started on
intravenous narcotics from just about the minute they reach the recovery room,
the goal being to “stay ahead” of the pain. Narcotics are difficult to
purchase, manage, and distribute on these missions. So most patients just received an acetaminophen suppository at the end of the surgery, then 1000mg acetominophen (two extra-strength
Tylenol) and 400mg ibuprofen (two Advil) every 6 hours. In Cambodia we added ice packs, but in the
temperate climate of 5000ft Baguio, I didn't seen that approach.
Most postop patients
cope well. Except for Olivia, who couldn’t
tolerate even the brush of a finger on her abdomen. So she got some Vicodin, a moderate narcotic
that I brought and was much appreciated. Out of 26 patients just 4 (two of whom had ibuprofen allergies) needed narcotics, each receiving 4-8 Vicodin tablets.No privacy on an open ward, with beds only 12-18 inches apart, but observing others manage postop issues may benefit all.
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