John Stork, MD,
Pediatric Anesthesiologist, Co-Director, Rainbow Comfort Team, UH Rainbow Babies & Children’s Hospital
No parent wants to see a child hurting. But about 5 million young patients have surgery each year and around 75 percent will feel pain afterward. Others may have pain from non-surgical problems. “You can work with your child’s care team to reduce pain and its effects,” says John Stork, MD, a pediatric anesthesiologist and Co-Director of the Rainbow Comfort Team at University Hospitals Rainbow Babies & Children’s Hospital.
Step 1: Recognize pain
Young patients cannot always explain feelings in the same language adults use. So some people — even doctors — incorrectly assume kids do not hurt as much as grown-ups. This can lead to inadequate treatment of children in pain.
“Before surgery, ask your child’s doctor what types of anesthesia and pain management are planned,” says Dr. Stork. “Then, talk with your child about what he or she is likely to feel during and after the procedure. Use age-appropriate words, like ‘sore,’ when needed.”
Doctors and nurses can explain how to gauge pain. Young children express hurting through body language, such as making faces or restlessly moving. Ask older children often how they are feeling. The doctor may provide tools to help them answer, such as a row of crying or smiling faces. Toddlers through teens can point to the one that best matches their mood.
Step 2: Ease the pain
While your child is in the hospital, doctors and nurses will help with pain management. They will start by regularly measuring your child’s pain using a scoring system, such as the faces pain scale. For older children, they may ask more detailed questions, giving your little patient the chance to express feelings. They might also ask you and other members of the health care team about changes in your child’s mood or behavior.
If signs indicate your child is hurting, they will take action. The care team may administer pain medications through an IV. Or, your child may receive drugs by mouth, under the tongue or through the rectum. Some children may have had regional nerve blocks during surgery, and a catheter may have been left in place for a continuous infusion of local anesthetic to the nerve. This is often very effective. Mental techniques, such as refocusing attention on a game or story, may help.
Step 3: Manage pain at home
Some parents worry about giving their child pain medicine after returning home. One recent study found that nine in 10 parents thought their children were in pain after getting their tonsils out. But only one-fourth gave their child even one dose of medication.
It is true that some pain drugs can be harmful for young patients. But not treating pain is also risky. Children who remain hurting after surgery may not recover as well, Dr. Stork adds. They may develop long-term problems, such as chronic pain, behavior changes and disability.
Talk to your child’s doctor about pain relief options, including:
- Over-the-counter medications. Acetaminophen and ibuprofen are available in child-friendly drops, syrups and chewable tablets. Always carefully read labels and ask your doctor or pharmacist if you are unsure about dosage.
- Prescription drugs. These include opioids and stronger doses of ibuprofen or acetaminophen. Your doctor will talk with you about properly using them for the right length of time to prevent tolerance or dependence.