I have had 2 ACDFS; very painful, to say the least. My first procedure was done with bone graft from my hip. Although many patients state the hip pain is the pits,
it wasn't bad at all for me. I found ice to the sites (neck and hip) really helped! The first time around, my surgeon would only use IM Demerol, and it helped, but I was getting 200 mgm q4 hours due to pre-op narcotic use for pain control. I would not recommend this analgesia to anyone..takes too long to work when pain relief is needed "today, not tomorrow!"
The second time around, a PCA Dilaudid was a Godsend! Went home the next day, unlike the 1st time; I was hospitalized for 4 days. There was absolutely no use of Toradol; suppresses the inflammatory response. I had no issues with vocal cords the 1st time around d/t surgical technique. However, the 2nd time the surgeon (a different one), went in through the right side of my neck, and I ended up with hoarseness and dysphagia, necessitating a laryngoscopy and an esophagoscopy. This prolonged my recovery. Positioning was a "biggie" in the PACU; one pillow under each arm, and one under the neck..provided much comfort.
As a former PACU nurse, I took care of a patient who had a cervical fusion done with a posterior approach. His dressing was saturated with blood upon arrival to the PACU. He MAE; when I took the drsg down, there was no further bleeding, and there was no further movement, either. He had an epidural hematoma! A stat page to the surgeon got him back to the OR PDQ; all turned out well, his paralysis lasted for 15 minutes..evacuation of the hematoma did the trick; there was no residual paralysis..check the dressing, as well as neuro status FREQUENTLY!