A patient’s guide to pain management for your child after surgery

It is important that you and your child are included in all pain management decisions. A multidisciplinary pain team including doctors, nurses, pharmacists and physiotherapists will be involved in controlling your child’s pain. There is also a specialist acute pain team, consisting of anaesthetists and nurse specialists who will visit the ward every day and will speak to you and your child if your nurse highlights a pain issue, or if your child is using an epidural or Patient Controlled Analgesia (PCA). If you have any particular concerns, you may ask the nurses to contact the acute pain team. At night and at the weekend, the acute pain team is covered by our oncall anaesthetist, who will come and see you and your child if called by your nurse.

On the day that your child is admitted to the ward, your nurse will talk to you and your child about previous pain experiences. Make sure that you tell the nurse of any or if your child is using regular pain relief medicines.

An anaesthetist (doctor who cares for your child while they are under anaesthetic) will visit you and your child on the ward. He or she will talk to you about the anaesthetic and also about the pain relief suitable for your child during and after the operation or procedure. If your child has had surgery before, it can be helpful to tell the anaesthetist which ways of managing your child’s pain have worked well before, or if anything did not work well. The anaesthetist may give your child some medicine just before the operation or procedure to help with anxiety or pain.

If you feel it is necessary to speak to a member of the Acute Pain Team prior to the operation, please speak to a member of staff in order for this to be arranged.Add

The anaesthetist will give your child pain relief medicine during the operation or procedure and in the recovery room so that they are comfortable when they get back to the ward. The anaesthetist or the surgeon may also use local anaesthetic to numb up the area being operated on.

The pain relief medicine or local anaesthetic given during the operation or procedure gradually wears off, so your child will need to continue to have pain relief medicines on the ward to control pain.

After surgery, a variety of pain relief medicines may be used. These can be changed or combined until the most effective one is found for your child. Pain after an operation or procedure has a limited duration, and as it gets better we will adjust the pain relief medicines to match your child’s pain level. The pain may also change in character over the course of your child’s recovery; for example the initial sharp surgical pain may be followed by a period of crampy muscular pain. We may adjust their pain relief to account for this.

The nurses will assess your child’s pain regularly in order to see if the pain relief they have had is effective and to help them plan further management. They use different tools to measure pain, depending on the child’s age and ability to communicate. The nurses will also ask your opinion about your child’s pain. They can give your child further pain relief medicine. If the pain is not controlled satisfactorily the acute pain team will be contacted.

You know your child best. You understand how they express pain and can manage their pain effectively. Your opinions will always be respected. If you feel that your child is in pain at any time please tell the nurse.

Persuading your child to take medicine can sometimes be difficult and we might need your help with this.

Play and distraction therapy helps children to focus less on their pain. You will be able to help us with this very important aspect of their care. There are play specialists on the ward who will help with this. You may also bring items from home

Your child may need to continue some pain relief medicine for a short while after they leave hospital. Different types of pain relief medicine work well together so you may be given more than one medicine for your child to take at the same time. For example, paracetamol and ibuprofen work well together. At first it is usually better to give some pain relief medicine regularly to prevent pain, rather than waiting for it to get very bad. As well as medicines to take regularly to help with normal pain, you may be given a stronger pain relief medicine for your child to take only when the pain gets bad.

You will be given a prescription with all your medicines, labelled with instructions on how to take your medicines and how much to take depending on the weight and age of your child. The exact medicines we give you will be based on what has worked for your child while in hospital.

If your child experiences continued pain despite this medicine, please call the ward for advice or contact your GP.

If your child does not use all the tablets/liquids that have been given then you should return them to your local chemist.

Do not put them in your local bin or flush them down the toilet.

If your child is still experiencing pain and needs more medication, you can buy paracetamol and ibuprofen from your pharmacy. However, for any stronger medication your child will need a prescription from your GP. You will need to make an appointment for your child to see the GP who will review the pain and if required give you a new prescription for your child