I had 3 steel pins hammered into my right hand 2 weeks ago at a major tpe hospital.
They tried regional anestesia and when that failed they put me under.
When I woke up in the recovery room, the nurse asked me if I was feeling any pain. I was in a bit but not unmanageable, however her offer og 30mg of something morphine related was too good to turn down. It worked.
Once i got back into the ward, the nurses there offered me a shot of Demerol. It worked too.
After 3 hours I started to feel pain. I asked for another shot and got it. It worked.
Toward the evening when it was established that I was able to eat, drink and pee, they gave me a strong long lasting NSAID (should last 24 hours). It did not work, so after one hr I told the nurses. They looked disbelieving at me, and got a shot of Demerol hustled up in no time. Once that kicked in, the NSAID took over and kept me free from pain for 24 hours, or till they gaveme the next tablet. They then sternly told me to let them know when the pain started, after all the first 24-36 hours their objective was to ensure that i was comfortable enough to sleep and eat, if i was in serious pain after that, then something serious would be wrong. I must admit that they managed the pain rather well.
I speak Chinese and my wife was on hand to drive the message in [I briefed her beforehand]. That said, all I had to do wasto ask when they checked up on me.
I was let to believe that it was the standard modus operandum at that hospital.
Interestingly enough demerol and other painkillers was refused by a lot of the chinese, as they believe that it's bad for you. The guy next to me refused all painkillers after a knee operation and he looked suffering. Poor bloke, when he finally asked for one, his wife instructed the nurses not to give him anything.
From day 2 I did OK on NSAID's and from the moment I left the hospital, I haven't taken anything.
Interestingly enough my wife talked about the chinese aversion to opiate painkillers. I asked her if she wanted me to refuse painkillers on her behalf in case she has to have surgery done. [Note I have a rather dark sense of humor]. My wife's reply was that she was not like most Chinese.
Funnier still, my dad does the kind of surgery I was subjected roughly 50-100 times per year. he told me that 600mg of ibobrufene works better than opiates on localized pain after orthopaedic surgery. Local orthopaedics however don't use it as it has a small negative impact on bone healing times afterward.