What's in Your IV Pain Meds?

The Differences Between Commonly Used IV Pain Medications

Intravenous (IV) pain medications are frequently used in the hours and days after surgery to control pain. Pain is typically the most severe in the 72 hours after surgery, which, unsurprisingly, is when patients are most likely to receive potent pain relievers.

Many pain medications that are available as a pill can also be given by IV. Common IV pain medications include non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, and opioid medications, such as morphine.

This article discusses why IV pain medications are used and what the common IV pain medications are. It also covers the risks of prescription pain medication and some of the alternatives to IV medications.

Nurse setting up IV
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Why IV Pain Medication Is Used

IV pain medications are usually given in the initial hours following surgery. The patient may still be under the influence of anesthesia, and it isn’t safe to take oral medications until they are awake enough to swallow without choking.

If the patient cannot take pain medication as a pill, or they need a medication that will work very quickly, IV pain medication will usually be given.

The main benefit to IV pain medication over other forms of medication is that it typically takes effect very quickly, often within minutes because it is moving directly into the bloodstream.

Once discharged from the hospital, it isn’t practical to use IV pain medications, as most individuals do not return home with an IV site in place. Pills or another form of non-IV medication will typically be prescribed.

Common IV Pain Medications

If your pain medication is given by IV, it may include an NSAID, like acetaminophen, or an opioid like fentanyl. Your healthcare team will decide on a medication based on factors such as your level of pain and the type of procedure you had.

You may also hear pain medications referred to as analgesics. This is a term used to describe a medication used for pain relief.

Some of the available IV pain medications include:

  • Ketorolac: This medication is in the NSAID family, and it is used to treat mild to moderate pain. It also has anti-inflammatory effects.
  • Ofirmev (acetaminophen): This medication, an NSAID, is an IV form of the active ingredient in Tylenol. It is used as a fever-reducing agent that also can treat mild pain.
  • Caldolor (ibuprofen): This medication, also an NSAID, is an IV form of the active ingredient in Advil. It is used to reduce mild to moderate pain and inflammation and has some ability to reduce fever.
  • Morphine: An opiate pain reliever originally derived from opium, morphine is used to reduce moderate to severe pain. Morphine is frequently used for both acute pain and long-term chronic pain.
  • Dilaudid (hydromorphone): An opioid pain reliever, Dilaudid is very potent and is used to treat severe pain after surgery.
  • Fentanyl: An opioid pain reliever, fentanyl is used to control severe pain after surgery.
  • Demerol (meperidine): This medication, an opioid analgesic, is no longer used as frequently as it was in the past. Demerol is less likely to control pain and more likely to cause euphoria and delirium than other types of pain medication. It is occasionally used off-label (outside of typical use) to help decrease shivering in patients who are being cooled, due to fever or the need for hypothermia as a treatment. It’s no longer routinely used for the control of surgical pain.

The terms opiate and opioid refer to the origins of medications in the poppy plant, from which opium is extracted. The opiates morphine and codeine are derived from opium, while opioids such as hydromorphone and meperidine are synthesized. The term opioid is often used to refer to opiates as well.

Risks of Prescription Pain Medication

Pain medications used after surgery have a number of possible risks and side effects:

  • Sedative effects: These effects range from the mild (feeling sleepy) to severe (not breathing). Due to the risk of sedation, these medications should not be taken when operating a car. Take pain medication as directed to avoid an unintentional overdose.
  • Constipation: All opioids, whether they are given as a pill or an injection, are known to cause constipation. Many patients take a stool softener daily to prevent constipation when taking opioid pain medication.
  • Addiction: Inappropriate and/or extended use of opioids can lead to a physical and mental addiction. Opioid pain relievers should not be taken any longer than absolutely necessary.
  • Nausea/vomiting: Some individuals don’t tolerate this type of medication well and it causes nausea and vomiting. For some, pre-medicating with an anti-nausea medication such as ondansetron may prevent or reduce these symptoms.
  • Itching: Prescription pain relievers are well known to cause itching. For some, changing to different pain medication will provide relief, others require a medication known to reduce itching such as Benadryl (diphenhydramine) or prescription Vistaril (hydroxyzine).

Alternatives to IV Pain Medications

Besides IV pain medications, there are other options for pain management after surgery. Your healthcare provider may offer alternatives to help reduce dependence and side effects, particularly from opioids.

Some pain management alternatives after major surgery include:

  • Wound infiltration: A small tube called a catheter is placed in the surgical wound to deliver local anesthesia.
  • Epidural: A catheter is placed in the epidural space in a patient’s back to deliver a continuous infusion of local anesthetics.
  • Peripheral nerve blocks: A catheter delivers a local anesthetic to provide pain relief by blocking pain signals from a targeted nerve.

After you’re ready to go home after surgery, your healthcare provider will provide you with instructions for pain relief. You may be given opioid medications in pill form. These are to be taken at the lowest dose possible and for the shortest time possible to minimize the chance of side effects or dependency.

To avoid opioid complications, your healthcare provider may recommend non-opioid pain relievers like Tylenol (acetaminophen) and Advil (ibuprofen) after surgery. According to one study of knee arthroscopy patients, 82% of patients were able to control their pain with non-opioid pain management.

Summary

IV pain medications are used in the hours after surgery to help manage pain. They’re often prescribed when the patient is still under the influence of anesthesia and isn’t able to take oral medications. Common IV pain medications include NSAIDs, such as ibuprofen, and opioid medications, such as morphine.

IV pain medications may cause risks and side effects, including constipation, vomiting, and addiction. Your healthcare provider will work with you to find the best option for pain relief in the hours and days after surgery.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Jennifer Whitlock, RN, MSN, FN
Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.