After surgery, there may be physical causes of pain. But how a child feels pain 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 normal 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 If your child is unusually agitated or withdrawn, let your child's healthcare team know. They can change medicines or try a different dose to help.
There are many pain medicines that your child can get. 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. He or she will also take into account your child's age and development, and any past experience your child has had with surgery and pain medicines.
If your child has moderate to severe pain, he or she will most likely get opioids during and after surgery. If your child is in the ICU after surgery, he or she may also get sedatives. Sedatives can ease anxiety, help your child sleep, and erase the memory of unpleasant events. Opioids are not addictive when used for appropriate short term pain control after surgery.
Non-opioid pain relievers 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 or IV (intravenous) medicines can be used as needed.
Your child may have an 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.
During some surgeries, epidural anesthesia is used. This 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.
PCA stands for patient-controlled analgesia. With a PCA pump, your child can get a continuous dose 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. The dose is determined by your child's healthcare provider, and your child can't give him- or herself too much. 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 correctly. In some cases, a parent or nurse is allowed to control the PCA pump for younger children. This is known as authorized agent-controlled analgesia.
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.
Parents can comfort their child better than anyone else. These suggestions might help you comfort your child:
All children need to be held, stroked, and touched by those that are most important to them. Ask for help from the nurse if you want to hold your child, but aren't 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. It can also distract your child. 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 your child can watch movies or children's 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 ease muscle tension.
Ask to speak with a child life specialist who may be able to offer more coping strategies for your child.