Outpatient Surgical Pain

Many children undergo operations. The amount of pain an operation causes depends on the kind of surgery and the child. In addition to making your child feel bad, pain after an operation can slow a child's recovery, slow the bowels and interfere with breathing and physical therapy.

The first two days after the operation are usually the worst. Some children will have very little pain by the time they go home; others will need regular doses of pain medicine for a few days. After that, things usually start to get better. There are many ways to help children be comfortable after surgery. Ask your child's doctor which ones are right for your child and the operation he/she is having.

  • The incision or cut the surgeon made.
  • Muscle spasms, or cramps, which can be very painful after orthopaedic surgeries.
  • Bladder spasms, or cramps, which often occur after surgery on the bladder.
  • Air or blood inside the belly or chest, which can cause pain that is felt in odd places far away from the surgical site, such as the shoulders or back. This is called "referred pain."
  • Backaches or other muscular aches can become a problem if a child lies on his/her back without moving for a few days or can result from the position a child had to be in during certain operations.

Older children will say they hurt, although sometimes they cannot describe their pain clearly. Younger children may cry, or hold very still and try not to move. Appetite may be poor and children may either sleep a lot or have problems sleeping.

Pain from a surgical incision tends to hurt all the time. Cramps and spasms seem to come out of nowhere and then fade away again. You may or may not see muscles tighten. Your child's nurse or doctor will be able to help sort through some of the unusual ways pain appears after surgery.

For the first day or so, your child may need strong pain medication. In the operating room, the anesthesiologist may give medication such as morphine, to allow your child to wake up comfortably. Once your child feels well enough to eat or drink, then medicine can be given by mouth.

Your child's surgeon will write a prescription for pain medication for you to give your child at home. Please get this prescription filled right away so that you can "stay ahead" of your child's pain. Staying ahead of pain means to give pain medication before your child experiences pain at its worst. It is easier to stay ahead of pain than to catch up, and it takes less medicine to keep comfortable. Good pain control will help your child recover and feel better soon.

Pain medicines prescribed can include acetaminophen (Tylenol), acetaminophen with codeine, oxycodone (Percocet, Roxicet, Tylox), hydrocodone (Vicodin), morphine, or other similar medicines. Plan to give these medications regularly for the first day or so, to keep the pain from getting out of control.

In addition, anti-inflammatory medicines such as ibuprofen might be used, but you should call your surgeon before giving your child this type of medicine after surgery. If your child has bladder or muscles spasms (cramps), the doctor may prescribe one of these medicines: diazepam (Valium), oxybutynin (Ditropan), methocarbamol, or baclofen. These medicines should help make the spasms more bearable.

Do not give more pain medication than instructed. If the medication is not working, call your child's doctor. If you are not sure if the dose is right or if you are giving the medicine right, call your child's doctor.

As with all medicines, keep the pain medicine in a safe place, away from children and animals.

You should not worry about your child becoming addicted to pain medication. This would be very rare, unless the child already has a problem with drugs or alcohol.

Once the pain begins to get better, most children do not like the way the pain medicines make them feel and they use less and less, even if they are allowed to use as much as they want.

If your child has had a caudal block or other nerve block, he/she will be numb for several hours after surgery. The numbness from the block will then wear off. Plan to start giving the prescribed pain medicine as soon as your child mentions that he/she is becoming uncomfortable, or looks like he/she is in even a little bit of pain.

  • Your child's pain is not controlled
  • Your child is too sleepy
  • Your child is not making sense when he/she talks
  • Your child experiences nausea, vomiting, or itching
  • You are unclear on how to give your child's pain medication.

At Cincinnati Children's, you can expect your child to be made as comfortable as possible. The hospital staff will also try to keep side effects to a minimum. Unfortunately, there are times when a pain or discomfort cannot be made to completely go away. Other times, there will be unavoidable side effects. The doctors and nurses will do their best to make your child's experience the best it can be.

Last Updated 12/2013