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Without reading any study information, I bet in studies like these, there's a way to opt out and be given a proven one (at least assuming there aren't concerns about how they'd interact with the experimental ones, though I'd also expect those to be understood from the safety studies).
The opt out option wouldn't even make that participant's contribution worthless because someone begging to no longer do the study would be a good indicator that the pain med isn't working well. "Time between administering drug and requesting exit from study" could even be used as an indicator to see if there's any significant difference between the placebo and study drug, where the proven painkiller group acts as the control instead of the placebo group.
Though I don't know how these studies account for different pain tolerance levels and different amounts of pain from the procedure, which could even vary for people getting the exact same procedure, since there will be variance between exact location of cuts and such. There would probably be some placebo group members that won't complain of pain and proven painkiller group members that do complain (some just wanting more drugs, some experiencing pain, imagined or real, and some behaving as if they are in pain despite not feeling it).