Are you scheduled to have an operation? Or have you recently had one? The biggest fear for many people when it comes to surgery is the pain that occurs after the surgery. There are times when this pain makes it difficult to do normal work or even walk. So, in this article, we are talking about a special medicine solution that gives you a better control over this pain, in a slightly different way.
Simply put, what is this medicine?
This is a combination of two medications. That is
Bupivacaine and
Meloxicam . Let's see what happens with these two.
- Bupivacaine : This is like the numbing medicine you get before a tooth extraction. But because it's injected right where the surgery is being performed, it numbs the area completely. This stops the pain from going to the brain, and you feel much less pain. We call this a " local anesthetic ."
- Meloxicam: This belongs to the group of painkillers called NSAID (Nonsteroidal Anti-inflammatory Drug). It works by reducing swelling and inflammation caused by surgery. When the inflammation is reduced, the pain is also controlled to a great extent.
Simply put, this combination of two medications numbs the area around the surgical wound and relieves pain, while also reducing swelling in the wound and further controlling pain. This is not a pill or an injection into a vein.
This is a liquid that your surgeon instills into the surgical wound at the end of the surgery. So its effects can last for several days.
Things you need to tell your doctor before giving you this medicine:
Okay, this is very important. Before deciding whether this medicine is suitable for you, it is essential that the doctor knows the complete details of your health condition. Because, people with certain medical conditions need to be very careful when giving this medicine. If you have any of the following, you should definitely tell the doctor.
| Disease or condition | Why should you care? (in brief) |
|---|
| Asthma | NSAIDs can worsen asthma in some people. |
| Bleeding problems | This medicine may affect blood clotting. |
| If you have heart disease, heart attack, stroke, or have undergone bypass surgery (CABG) | NSAIDs can increase the risk of heart disease. |
| High blood pressure | Blood pressure may increase further. |
| Kidney or Liver disease | Because the drug is eliminated from the body through these organs, their function may be affected. |
| Stomach ulcers or bleeding | NSAIDs can cause these conditions to recur or worsen. |
| Drinking or smoking habits | Increases the risk of stomach bleeding. |
| If you are pregnant, trying to get pregnant, or breastfeeding | During pregnancy (especially after 20 weeks), there may be adverse effects on the baby. |
| If you have allergies to other medicines, foods or substances | This is not recommended, especially if you are allergic to aspirin or other NSAIDs. |
How do I use this medicine and what to do if I overdose?
This is not a medicine that you can take home. This is
a medicine that is used only by a surgeon in a hospital or clinic . Therefore, there is no need to worry about missing a dose or how to use it. However, if you experience any unusual symptoms after taking this medicine, it may be a sign of a drug intolerance or an overdose. If you have any doubts about such a thing, you should immediately call
the National Poisons Information Centre at the Colombo National Hospital or go to
the Emergency Department (ETU) of the nearest hospital.
The most important thing is that this is a medicine that was given to you only. Even if you talk to others about it, don't tell anyone else to use it because it's a "good medicine."
What other medications may interact with this medicine?
This medicine may interact with other medicines you are taking, increasing your risk of side effects. It is important to tell your doctor about all the medicines you are taking, including vitamins and herbal remedies. Be especially careful if you are taking any of the following medicines:
Medications that should never be taken, so inform your doctor about any other medications you are taking as they may cause interactions.
| Types of drugs that may cause conflicts |
|---|
| Cidofovir | Ketorolac (another strong NSAID) |
| - Blood thinners - Aspirin and other NSAIDs (e.g. Ibuprofen, Naproxen) - High blood pressure medications - Some diabetes medications - Steroids (e.g. Prednisone) | - Some medications for depression - Some medications for epilepsy - Some medications for cancer - Diuretics - Some supplements (e.g. garlic, ginger) |
Things you should be careful about when you have this medicine in your body
After this medicine is introduced into your body, there are a few things you need to be careful about.
Beware of accidents due to numbness
Since the surgical area is numb, you will not feel any pain there. Therefore, you should be careful not to hit or bruise the area. Even if you do not feel any pain, these can interfere with the healing of the wound.
Avoid taking other painkillers (NSAIDs)
This is very important. This medicine already contains an NSAID called Meloxicam. Therefore, you
should never take other NSAIDs like Ibuprofen, Naproxen, Diclofenac from the pharmacy without asking your doctor. Doing so greatly increases the risk of serious side effects such as stomach bleeding and kidney damage.
Be aware of stomach bleeding and injuries.
NSAIDs can damage the protective lining of the stomach. So if you experience symptoms like stomach pain, black stools, vomit that looks like coffee grounds, or vomit blood, it could be a sign of stomach bleeding. If this happens
, see a doctor immediately .
Risk of heart attack and stroke
Long-term use of NSAIDs can slightly increase the risk of blood clots, heart attacks, and strokes. If you already have heart disease, it's important to talk to your doctor about this. If you experience symptoms such as chest pain, difficulty breathing, or numbness on one side of your body, seek medical advice immediately.
Possible severe skin reactions
Very rarely, some people can have a severe allergic reaction to this medicine. If you experience fever, body aches, a red rash, blisters, or peeling skin, it could be a serious condition. So see a doctor immediately.
What are the possible side effects?
Like any medicine, this one can cause side effects in some people. Some of these are serious, some are common.
Serious side effects that should be reported to your doctor immediately are usually not serious (but tell
your doctor if they persist).
| Type of side effect | Symptoms |
|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue, difficulty breathing. |
| Bleeding | Black stools, vomiting blood or coffee grounds, red or dark brown urine. |
| Heart attack | Tightness in the chest, shoulder, arm, or jaw, difficulty breathing. |
| Stroke | Sudden numbness or weakness in the face, arm, or leg, difficulty speaking, difficulty walking. |
| Kidney or Liver injury | Decreased urine output, swelling in the legs, yellowing of the eyes or skin, pain in the upper right side of the stomach. |
| Methemoglobinemia (rare) | Blue lips or skin, extreme fatigue, difficulty breathing, rapid heartbeat. |
| Constipation | It can usually be fixed in a few days. |
| Headache | It may appear and disappear in small amounts. |
| Vomiting | Often temporary. |
Take-Home Message
- Bupivacaine and Meloxicam are special fluids that are injected into the surgical wound by the surgeon to control pain after surgery.
- Before this medicine is given to you, be sure to tell your doctor about all your medical conditions and all other medications you are taking.
- The surgical area is numb, so be careful not to injure it.
- While taking this medicine, avoid taking other NSAID painkillers such as Ibuprofen and Diclofenac without consulting your doctor.
- Seek immediate medical attention if you experience any serious symptoms, such as black stools, chest pain, difficulty breathing , or a severe skin rash.
Bupivacaine, Meloxicam, surgery, pain, painkillers, surgery, side effects
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