Pain Control After Your Child's Surgery

Will my child be in pain after surgery?

After surgery, there may be physical causes of pain, but the sensation of pain also depends on many mental and emotional factors. Knowing how much pain your child has can be a challenge. Your child's healthcare team may use a scale of 0 to 10 or illustrations of faces to help your child describe pain. Many hospitals have an acute pain service (APS) team that will help manage your child's pain while in the hospital. The healthcare providers caring for your child can determine what is usual discomfort for a certain operation and give the prescribed medicine. However, as parents, you know your child best. If your child is unusually agitated or withdrawn, you should let your child's healthcare team know so they can further assess the effectiveness of the prescribed medicine.

What pain medicines will my child receive?

There are a wide variety of pain medicines that your child can receive. Your child's healthcare provider will order the specific medicine(s) he or she thinks will be most effective. This is based on the type of surgery your child had, your child's age and development, and any previous experience your child has had with surgery and  pain medicines.

If your child has moderate to severe pain, he or she will most likely receive opioids during and after surgery. If your child is in the ICU after surgery, he or she may also receive sedatives along with pain medicines. Sedatives can decrease anxiety, help your child sleep, and eliminate the memory of unpleasant events. Opioids are not addictive when used for appropriate pain control.

How will my child receive pain medicine?

If your child is receiving non-opioid pain relievers, they are often given in pill form for older children and as a liquid medicine for younger children. Sometimes, your child may have nausea and vomiting after surgery; in this case, suppositories can be used if needed.

Your child may have an intravenous (IV) line after surgery, especially if he or she is staying in the hospital overnight or longer. Many pain medicines can be given in the IV fluids that are infusing into your child's vein.

What is an epidural pump?

During certain surgeries, epidural anesthesia is used. This type of anesthesia is given through a small catheter into the space surrounding the spinal cord. The catheter can be connected to a pump that will give a constant flow of medicine. After surgery, this catheter can be left in for a few days.

What is a PCA pump?

PCA stands for patient-controlled analgesia. With a PCA pump, your child can receive a continuous dosage of opioid medicine through an IV, or an intermittent dosage, or both. With intermittent dosages, your child decides when he or she feels bad and pushes a button that gives a dose of pain medicine. For example, your child may come back from surgery with a PCA pump that has been programmed to give pain medicine at a continuous dosage every hour. The pump can also be programmed for your child to give additional amounts of medicine when he or she needs it, by pushing a button. The dosage is determined by your child's healthcare provider, and your child can't give him- or herself too much. The day after surgery, your child's surgeon may stop the continuous infusion, and then only intermittent doses will be given when the button is pushed. The pump settings can only be adjusted by your child's healthcare team with a special key. Children as young as 4 years old have been shown to use PCA pumps effectively.

Will my child receive analgesics (pain medicines) at home?

Your child's healthcare provider will discuss with you the need for medicines at home. If your child will still need opioids, you will be given these prescriptions before your child is discharged.

Relieving my child's discomfort

Parents can comfort their child better than anyone else. The following are some suggestions that might prove helpful in comforting your child:

• All children need to be held, stroked, and touched by those that are most important to them. Ask for help from the nursing staff if you would like to hold your child, but are not exactly sure how to go about it because of equipment or bandages.

• Play is a familiar part of your child's day. It can help relieve tension for both of you, and can also provide distraction that helps your child feel better. If your child is able to be up out of bed, ask about the playroom in the hospital that he or she can go to. Also, bring story books, coloring books, puzzles, board games, and other toys that can be used in bed.

• Ask if a DVD player is available so that your child can watch movies or children's entertainment programs. Ask about the hospital's video game center that your child can use in bed or in the playroom.

• Music can be very comforting and has been shown to relieve muscle tension.

• Ask to speak with a child life specialist who may be able to offer more coping strategies for your child.