Pain is an unpleasant feeling or discomfort. How much, how long, and what type of pain or discomfort each child has depends on the child and the procedure.
Pain is often worse in the first few days. Pain can be:
- Mild, moderate or severe
- Sharp, dull, burning, spasm, throbbing, stabbing, pressure, aches or gas
- Clearly seen or harder to notice depending on your child’s activity level, sleep and eating patterns
- Short-lasting, every once in a while, or long-lasting
Pain from a surgical incision (surgery cut) tends to hurt all the time. Cramps and spasms seem to come out of nowhere and then fade away again. Other general pains such as sore throat or headache are common for the first 24 hours.
Children can have pain and not show it very clearly. We will ask your child how they feel. If your child is too young or not able to answer, we will ask you how you think your child is feeling. As a parent, your point of view on your child's comfort is very important.
Pain scales also help measure the amount and type of pain that your child is feeling. The care team will select and review the pain scale for your child based on their age and level of development.
Two types of pain scales that may be used are:
- Observation (watching their behaviors)
- Self-reporting (asking them to use pictures of faces or a number scale to rate their pain)
Why is Managing Pain Important?
Pain can slow your child’s healing process. Pain can affect your child’s:
- Ability to cough or deep breathe
- Sleep and energy levels
- Ability to eat like normal
These changes may increase your child’s risk for other problems.
Research shows that children whose pain is well controlled get better faster and have less problems and lasting effects.
During the Procedure
Your child’s care team will make your child a customized (special for your child) anesthesia plan that includes pain relief medicine. Your child’s plan depends on the procedure and your child’s medical and psychological condition. The care team will explain how the pain relief medicine and other pain treatments work.
Your child may get pain relief medicine such as:
- Opioid (narcotic) through an intravenous line (IV) or by mouth (e.g. fentanyl or morphine)
- Non-opioid pain relief medicine through an IV or by mouth
- Regional or nerve block (numbing medicine)
Pain relief medicine can cause side effects. The care team will try to reduce these side effects as much as possible. Sometimes side effects cannot be avoided.
Many pain relief medicines may decrease how often and deeply your child takes a breath. Your child’s care team may need to limit these types of medicines to reduce the risk for breathing problems. To help stop these side effects and avoid addiction, only take these medicines under your provider’s care. Your child’s care team has the skill to safely give these medicines.
After the Procedure
Your child may have pain even though they were given pain relief medicine during their procedure. Some children need extra pain relief medicine in the Post Anesthesia Care Unit (recovery room). As the pain relief wears off, your child may need to keep using pain relief medicine and comfort methods in the hospital and at home.
Since no child is the same, the type of pain relief medicine and how long it is needed will vary. Ask your child’s care team about your child’s pain management plan.
In the Hospital and While at Home
Some things that may help your child be more comfortable:
- Find a relaxing position: Try using blankets or pillows to help create a comfortable space. Hold or rock your child as allowed by your child’s provider.
- Distract with activities. Help keep your child’s mind off the pain with music or quiet activities. Suggestions for activities are watching a video or using hand-held electronics.
- Distract with conversation. Talk about things not related to the hospital or surgery (friends, favorite movies, favorite toys or games, their pets or school).
- Use humor. It can improve your child’s mood and change their attention.
- Talk about ways to cope. “If you do this _____, you will get better.”
- Encourage relaxation techniques. Try deep and steady breathing or meditation.Encourage relaxation techniques such as deep and steady breathing or meditation.
- Use cool or low heat. Ask your child’s provider if a cool or low heat source is allowed.Make use of cool or low heat for comfort as allowed by your child's provider.
Your child’s provider may also suggest a pain relief medicine for home. They may:
- Tell you to use over-the-counter (OTC) pain relief / fever reducing medicine
- Give you a prescription for pain relief medicine:
- Fill your child’s script right away.
- Ask the care team when your child can start this medicine.
- Do not use this medicine if your child is too sleepy.
When giving medicine at home, follow the instructions on the bottle.
- Do not give more medicine than instructed.
- If you are not sure if you are giving the right amount or if you are giving it the right way, call your child’s provider.
Pain relief medicine may work better when given before your child’s pain is at its worst. Your child’s pain may increase if you are trying to wait or not give pain relief medicine. It can be very hard to reduce pain after it has become moderate or severe.
Use the pain scale handout “Parent’s Postoperative Pain Measure (PPPM)”, which may be given to you before discharge, to help you measure the amount of pain your child is having. The score will show you when they may need their pain relief medicine.
Your child’s provider may limit or suggest activities that promote healing. While taking pain medicine such as an opioid:
- Assist them when they walk or crawl.
- Assist them when going up and down stairs.
- The child should not drive or use heavy machinery.
Call Your Child's Provider if Your Child:
- Has pain that prevents them from being able to rest, sleep, or be comforted
- Is overly sleepy, and you cannot wake your child easily
- Is not making sense when they talk
- Has side effects such as an upset belly, throwing up, itching, trouble peeing or pooping
Concerns about Addiction
It is rare for a child to become addicted to pain relief medicine. Long-term use of opioid medicines can be addictive. It is best to talk to your provider if you have concerns about this due to the child or a family member with addiction problems.
Cincinnati Children’s Pharmacy
Acetaminophen (Tylenol®) is sold at a reduced cost at the outpatient pharmacy on the Burnet Campus and Liberty Campus. Pharmacy hours vary by location.
Safe Medicine Storage and Disposal
- Store all medicine in a safe place and out of reach of children.
- Lock up opioid medicine.
- Keep medicine in original package.
- Always use a child-resistant cap.
- Relock the cap after each use.
The preferred and safest way to get rid (dispose) of medicine is to drop it off at a medicine collection site. This keeps medicine out of the water system, out of the hands of children or pets, and out of hands of those who might misuse or abuse it.
If a medicine collection program is not available, follow these steps:
- Take the medicine out of the bottle and put it in a bag that you can seal. (Do not open or crush capsules or tablets.)
- Mix kitty litter, coffee grounds, dirt, or ashes into the bag.
- Seal the bag and place it in a trash can as close to trash day as you can.
- Remove or mark out your personal info on the bottle. Then, throw the bottle away or recycle it.
- Patient info sheets that come with the medicine may also tell you how to dispose of medicine that is not in pill form.
- Visit FDA.gov for a list of medicines you can flush.