Understanding your child's pain after surgery

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 pictures 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's normal discomfort for a certain surgery and give the prescribed medicine.

But as parents, you know your child best. If your child is unusually disturbed or quiet, let your child's healthcare team know. If your child is non-verbal or shows pain in unique sounds, facial expressions, or body movements, let the healthcare team know. They can alert other team members to your child's pain symptoms and change medicines or try a different dose to help.

What pain medicine will my child get?

There are many pain medicines that your child can get. Your child's healthcare provider will order the specific medicine they think will work best. This is based on the type of surgery your child had and your child's age. The provider will also consider any past experience your child has had with surgery and pain medicines.

For moderate to severe pain, your child will most likely get opioids during and after surgery. If your child is in the ICU after surgery, they may also get sedatives. Sedatives can ease anxiety, help your child sleep, and erase the memory of unpleasant events. Opioids aren't addictive when used for short-term pain control after surgery.

How will my child get the pain medicine?

Nonopioid 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 or may not be allowed to eat or drink. In this case, suppositories or IV (intravenous) medicines can be used as needed.

Your child may have an IV line after surgery, especially if they are 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 some surgeries, epidural anesthesia is used. This is given through a thin tube (catheter) into the space around the spinal cord. The catheter is connected to a pump that will give a constant flow of medicine. After surgery, this catheter can be left in place for a few days.

What is a PCA pump?

PCA stands for patient-controlled analgesia. With a PCA pump, your child can get a continuous or occasional dose of opioid medicine through an IV. With occasional doses, your child decides when they feel bad and push a button that gives a dose of pain medicine. The dose is determined by your child's healthcare provider. Your child can't give themselves too much medicine. The pump settings can only be adjusted by your child's healthcare team with a special key. Children as young as age 4 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.

Will my child get 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.

How can I ease my child's discomfort?

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 safely do 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 can get out of bed, ask the nurse if you can take them to the playroom. Also, bring story books, coloring books, puzzles, board games, and other toys that can be used in bed.

• Movies and video games can help. Ask how 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.

• Some facilities have a child life specialist. This person is trained in helping children deal with the stress and anxiety of being in the hospital. They may be able to offer more coping ideas for your child.