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Managing Your Child’s Pain after Surgery

Managing Your Child’s Pain after Surgery

Managing a child’s pain after surgery is important in the healing process. Treating a child’s pain adequately speeds recovery and shortens the hospital stay, facilitates function and mobility after surgery, helps your child feel more relaxed and improves sleep.

Pain after surgery is primarily caused by the surgery itself, but your child’s experience can also be affected by psychological and emotional factors such as anxiety and stress.

Pharmacologic interventions refer to medicines that your child will receive. Using a combination of interventions in the treatment of pain has proven most effective as it addresses all sources of your child’s pain:

  • Pharmacologic interventions refer to medicines that your child will receive.
  • Non-pharmacologic interventions refer to therapies which alter thinking and focus to decrease pain. A child life specialist can help facilitate non-pharmacologic interventions.

If staying in the hospital overnight after surgery, your child may require intravenous medications to help manage pain and discomfort during the first 24 to 48 hours. These medicines are given through an intravenous, or IV catheter that is placed in the operating room and allows medicine to be delivered directly into the bloodstream. The IV will be removed before leaving the hospital.

Once your child is drinking and eating, he or she will receive oral pain medicine. Oral pain medicines are available either as a pill or a liquid and are given by mouth, swallowed by the child and absorbed through the stomach.

There is a doctor available 24/7 to ensure that your child’s pain control needs are being addressed when your child is admitted to the hospital.

Measuring Your Child’s Pain
We often use a pain scale from 0 to 10 as well as the FACES Pain Rating Scale to measure a child’s pain. We encourage older children to give a number for the pain they are feeling; 0 is no pain at all and 10 is the worst pain they have ever felt. For younger children we may ask them to point to a face on the scale of how they are feeling at that moment. We also keep in mind that all children feel pain differently and we treat them as individuals.

Wong Baker Pain Faces

Please encourage your child to be as honest as possible with his or her pain assessment so the proper medication can be administered to keep their pain under control. Let your child know that there is no shame in feeling pain and that we want to ensure that children are as comfortable as possible.

Helping Your Child Cope with Pain
We want parents to feel empowered to be included in their child’s care, including pain management. It is important to know that you can be an advocate for your child and be an active participant in decreasing your child's pain.

It has been shown the best results for reducing pain involves using alternative pain-relief methods along with medications. Child life specialists are available to help guide you and your child to appropriate pain relief methods, including:

  • Reading stories
  • Listening to music
  • Holding a familiar comfort item- stuffed animal, favorite pillow, etc.
  • Playing games
  • Having family members visit when possible

Deep breathing
Deep breathing is a slow and controlled exercise with the objective of relaxation. Relaxation is shown by positive changes in heart rate and blood pressure. Ultimately, this will lead to decreased physical and emotional pain. Participating in such a focused activity can take the patient’s mind off the pain and discomfort.

You can encourage deep breathing by…

  • Blowing bubbles
  • Counting as they inhale and exhale “Breathe in 1, 2, 3… breathe out 3, 2, 1.
  • Using a mental image such as blowing out the birthday candles

Guided Imagery
Guided imagery is a system of visualization that can be used to help in relaxation. In guided imagery, you are led to imagine all of the details of a particular situation. It is important to note that for the technique to be effective, an image that has strong emotional resonance for the patient must be used.

Often times a script, which describes the "place" the patient wants to be, can be followed for a guided imagery session. For example, if a forest is chosen as their imaginary place to go, the reader can set the scene by guiding the patient through their forest experience. The scripts will usually include what one would see, hear, smell, feel and sense all around.

Therapeutic Play
Providing children with the opportunity to play while in the hospital allows them to do what is familiar and normal for them. It not only provides them with materials to do what they would in their regular daily routine, it also gives them the opportunity to express what they are feeling during their hospitalization. Child life specialists often use therapeutic play to model coping methods for children to use, so they can gain control over their environment and decrease their fears and anxieties related to their hospital stay.

References for information used on managing pain

French, G.M., Painter, E.C., & Coury, D.L. (1994). Blowing away shot pain: A technique for pain management during immunization. Journal of the American Academy of Pediatrics , 93 , 384-388.

Huth, M.M., Broome, M.E., & Good, M. (2004). Imagery reduces children’s post-operative pain. International Association for the Study of Pain, 110 , 439-448.

Roberts, M.C., & Steele, R.G. (2009). Management of Pediatric Pain and Distress Due to Medical Procedures. In the Handbook of Pediatric Psychology (171-188). New York, NY, The Guilford Press.

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