Have you ever had to undergo a minor or major surgery? Or are you planning to have one in the future? If so, it is normal to be a little afraid of the pain that comes after surgery. But don't worry, today's medicine is very advanced. Doctors use various methods to control this pain. Today, we are talking about a special medicinal solution that is applied to the surgical wound itself and used to prevent pain for several hours.
What is this medicine? (Bupivacaine; Meloxicam)
Simply put, this is a combination of two drugs. It is marketed under the name ``ZYNRELEF''. It contains two drugs, Bupivacaine and Meloxicam .
Think of it like a needle that a doctor gives you before extracting a tooth. That numbs the area, doesn't it? Well, the Bupivacaine in this is what temporarily numbs the nerves where you had your surgery. Then those nerves stop sending pain signals to the brain, and you feel less pain.
The second drug is Meloxicam . This is a painkiller and a drug that reduces swelling. In medicine, we call this `(NSAID - Non-Steroidal Anti-Inflammatory Drug)`. This drug controls the swelling and redness of the wound after surgery. So, the combination of these two drugs will give you great relief from the pain of surgery for about 72 hours.
The important thing is, this is not a medicine you can take home. It is a special solution that a doctor instills into the wound during surgery in a hospital or clinic.
Things you need to tell your doctor before giving this medicine
Before deciding whether this medication is right for you, your doctor will need to know your complete health history. Be sure to tell your doctor if you have any of the following conditions:
| Health condition or habit | Description |
|---|---|
| Respiratory diseases | If you have lung diseases like asthma. |
| Bleeding problems | If you have a bleeding disorder. |
| Heart surgery | If you have recently (within 2 weeks) undergone heart bypass surgery (Coronary Artery Bypass Graft - CABG). |
| Heart disease and blood pressure | Conditions such as heart disease, high or low blood pressure. |
| Stomach and intestinal problems | If you have had stomach ulcers or bleeding in the past. |
| Kidney or liver disease | If you have any medical condition related to kidney or liver function. |
| Other habits and conditions | If you drink alcohol daily, smoke, or have G6PD deficiency. |
| Allergies | If you have allergies to Bupivacaine, Meloxicam, Aspirin or other NSAIDs, other medications, foods, or dyes. |
| Pregnancy | If you are pregnant, trying to get pregnant, or breastfeeding. |
What if there is an overdose of this medicine?
Since this medicine is given by a doctor in a hospital, the risk of an overdose is very low. However, if you think you may have had an overdose, you should immediately call the National Poisons Information Centre at the National Hospital , or go to the Emergency Department (ETU) of the nearest hospital.
Interactions with other drugs
This medicine can cause problems when taken with some other medicines, so it is very important to tell your doctor about all the medicines you are taking, including vitamins, herbal products, and supplements .
ZYNRELEF should not be used with these medications in particular:
- Cidofovir
- Ketorolac (another strong painkiller)
In addition, problems can also occur with the following medications:
- Other painkillers (e.g. Aspirin, Ibuprofen, Naproxen)
- Medicines that prevent blood clotting (e.g. Warfarin)
- Some medications for high blood pressure and heart disease
- Several types of antibiotics
- Diuretics
- Medications for depression (SSRIs, SNRIs)
- Types of medications given for fits
- Other specific medications such as Lithium, Methotrexate
This list is not complete, so it is best to tell your doctor about all medications you are taking before surgery.
Things to be careful about after taking this medicine
1. Be careful of the numb area: Since the area where the surgery was performed is numb, you will not feel any pain. Therefore, you should be careful not to bruise, injure, or burn the area.
2. Inform other doctors: If you need to have another surgery or medical treatment within 4 days of taking this medicine, tell the doctor that you have received this medicine.
3. Watch out for stomach bleeding: Meloxicam (an NSAID) in this medicine can sometimes cause stomach ulcers or bleeding. Smoking, drinking alcohol, getting older, and having poor health can increase this risk. If you have sudden stomach pain, vomit that looks like coffee grounds, or black, tarry stools , seek medical advice immediately.
Possible side effects
As with any medication, side effects can occur. Some are serious, some are common.
| Side effect | Symptoms |
|---|---|
| Serious side effects that should be reported to your doctor or ETU immediately | |
| Serious allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat, difficulty breathing. |
| Bleeding | Black stools, vomit that looks like coffee grounds, red/dark brown urine, red/purple spots on the skin. |
| Heart attack | Chest, shoulder, arm, or jaw tightness/pain, nausea, difficulty breathing. |
| Stroke | Sudden numbness/weakness in the face, arm, or leg, difficulty speaking, confusion, difficulty walking. |
| Kidney or liver damage | Decreased urine output, swelling of ankles/hands/feet, yellowing of eyes/skin, pain in the upper right side of the abdomen. |
| Methemoglobinemia | Headache, extreme fatigue, shortness of breath, rapid heartbeat, blue skin or lips (this is a condition that affects the oxygen carrying capacity of the blood). |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Constipation | Difficulty going to the toilet. |
| Headache | Headache. |
| Vomiting | Vomiting with nausea. |
Take-Home Message
- `ZYNRELEF` is a special medicinal solution that is applied directly to the surgical wound to control pain after surgery.
- Before you are given this medicine, be sure to tell your doctor about all your medical conditions and all the medicines you are taking.
- Since the surgical area will be numb after the medication is administered, it is your responsibility to take care not to injure the area.
- If you experience any symptoms of a serious side effect such as stomach bleeding, heart attack, paralysis, or severe allergic reaction, seek medical advice immediately without delay or go to the Emergency Department (ETU) of the nearest hospital.
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