If your child is having surgery, it's natural to worry about pain after the procedure. It helps to know what to expect and ways to keep discomfort to a minimum. Some common questions parents may have:
Will my child have pain after surgery?
Some pain after surgery is normal. Where the pain is and how long it will last depend on the type of surgery. Sometimes, changing positions or holding your child can ease their pain. Other times, medicines may be needed to help keep your child comfortable. Your child's nurses and doctors will work with you to help manage your child's pain.
How do I know if my child is in pain?
Everyone feels pain in their own way. The team of specialists involved with the surgery will help you figure out if your child is hurting. Babies and young children may not be able to tell you when they're in pain, but they usually show some symptoms. They may be more irritable than usual, for example. They may cry more easily or have trouble settling down. Or, they may not be as interested in feeding. Older children will usually tell you that they are in pain. They may even be able to tell you exactly where it hurts and what makes the pain better or worse.
How is pain from surgery treated?
Before the surgery. During a clinic visit or on the day of surgery, you will be asked about any past surgeries and things that usually help calm your child. The doctor may also ask about any pain medicines that worked well for your child in the past. This is a good time to ask any questions you have about how your child might feel after surgery.
Some children may feel anxious about the surgery and whether it will hurt. Studies show that children who are especially nervous before surgery tend to have more pain after the procedure. Talking with them about what to expect after surgery and how pain will be controlled can help ease their minds.
Your child might find it calming to listen to music before the surgery. A younger child might feel more at ease with their favorite toy. A child life specialist can also help your child feel more comfortable by talking or playing with them. In addition, the doctor can prescribe medicine to help them feel less nervous.
In the operating room. Good pain control starts during surgery. When possible, your child will get “numbing medicine" (local anesthetic) at the surgery site. Sometimes this can be used to numb the surrounding area, too (a regional block). Depending on the type of surgery, your child may also have the option to get pain medicine given into the space around the spinal cord. This can block pain for several hours to days. This is called either a “caudal block" or an “epidural." During the surgery, your child may also breathe in medicines and receive others through a vein to make sure they are comfortable.
After surgery. The goal is to make sure that your child is comfortable and is still able to get up and move around. To strike this balance, different types or medicines may be used, rather than relying on overly strong ones. Acetaminophen, ibuprofen, ketorolac, gabapentin, and clonidine are common choices. Opioids such as morphine, fentanyl, hydromorphone, hydrocodone, or oxycodone are sometimes needed and are safe when given in low doses for a short period of time.
At home. Many children are more comfortable and less anxious at home. Getting your child home as soon as possible is a top priority. It is important you feel prepared to take care of your child after leaving the hospital. The doctors and nurses will go over any pain medicines and other plans to keep your child comfortable at home. Be sure to follow any directions you're given about what medicine your child should take and how often it should be taken.
In addition to medicines, there are ways you can help make your child more comfortable at home.
Ice packs can help reduce swelling, which can decrease pain. Your child's surgical discharge team can explain how long and how often to use an ice pack.
Distraction, like reading books, playing games and watching movies, can help your child cope with discomfort.
A warm bath can also help ease pain, but check with your child's doctor how long to wait before getting the surgical site wet.
Stretching and walking, once your child's doctor says it's OK, can help with stiffness and pain.
A parent's touch or light massage, as long as it's far enough away from the surgery site, can help reduce pain.
Loose, comfortable clothing can help prevent irritation around the surgical site.
When should I call my child's doctor?
If your child has any of the following problems after surgery, call the doctor:
Pain that seems to be getting worse, is more intense or in a different location.
Pain does not get better with the pain medicine your child has been prescribed.
You have any questions about which type or when to give a pain medicine.