Pain After an Operation: Taking Care of Your Child's Pain at Home

You are taking your child home from the hospital after an operation. Your child will probably feel pain for the first few days at home. This brochure will give you some information about your child's pain. The brochure will also tell you how to care for your child when he is in pain.

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Name of your child's surgical clinic:

Phone number:

Contact person:

What you need to know about your child's pain

Most children have at least some pain after an operation. This is called post-operative pain. How much pain your child will have, and for how long, will depend on your child and the type of operation your child had.

Here are some things you should know about your child's post-operative pain:

  • Your child will probably have pain after his operation.
  • Not all children feel pain the same way.
  • In the days after an operation, the pain should get better, not worse.
  • Pain medicine will help your child hurt less.
  • Comforting your child will help him relax and relieve pain.
  • Distracting your child can also help relieve pain.
  • Comfort and distraction can be as important as giving medicine to your child.

Knowing if your child is in pain

Sometimes your child will say when he hurts. He may use words like pain, hurt, booboo, sore or ouchie. Your child may point to the part that hurts, or protect it. If he doesn't complain of pain, you can ask your child how much pain he has.

Pain Assessment Numerical/Visual Analogue Scale
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Children are asked to indicate their pain intensity by putting a mark on the scale.

If your child is older, the nurses in the hospital may have used a 0 to 10 pain scale to find out how much pain your child may have had. You can do the same. Ask your child to rate the pain on a scale from 0 to 10. Zero is no pain, and 10 is the worst pain ever. Mild pain would be 0 to 3, medium pain would be 4 to 6, and strong pain would be more than 7.

The nurses in the hospital may also have used a pain scale asking your child if he hurts a little or a lot.

Some children will not speak about their pain

Your child may not be able to talk or tell you about his pain. Watch your child carefully and see what you think. Parents often know if their child has pain.

What to look for to see if your child is in pain

Look and see if your child frowns, or kicks out his legs. Does he grind his teeth? Does your child pull his legs up to his stomach? If he moans or cries more than usual, or is stiff, your child may have pain.

Relieving your child's pain at home

Before you leave the hospital with your child, the doctor, advanced practice nurse, or nurse will tell you how you can help your child when he hurts.

Normally, if your child is in pain on the day he goes home, you can give him some pain medicine regularly during the rest of the day, and the next few days too, if needed.

Giving pain medicine regularly in the first few days after your child is home will help him to hurt less.

Don't wait to give pain medicine

Pain relief works best when you don't wait until your child is in a lot of pain before you give the medicine. If you wait, it may take longer for the pain to go away.

After the first few days, when your child hurts less, give the medicine only when he needs it. You will know that your child needs the medicine when he says it hurts. The way he acts may also show you that your child is in pain.

Acetaminophen (Tylenol or Tempra)

These are 3 different names for the same medicine. If your child is having mild pain, you can use regular acetaminophen every 4 hours.

The amount of medicine to give depends on your child's age and weight. Read the directions on the side of the bottle or box to find out the right amount, or dose, for your child's age and weight.

Acetaminophen is a safe medicine to give your child. There will be no major side effects when you give this medicine as explained on the box or bottle. Side effects are problems that the medicine itself causes.

Opioids: Hydromorphone, morphine, oxycodone

These are all different types of drugs called opioids. You can give your child an opioid if he is having a medium amount of pain at home. You can give oral hydromorphone every 4 to 6 hours, morphine every 4 hours, and oxycodone every 4 hours as needed.

The amount of medicine to give depends on your child's weight. Check the side of the box or bottle to find out the right amount to give to your child. You can also ask your child's doctor, advanced practice nurse, or nurse to tell you the correct amount to give.

Opioids are safe medicines to give your child in the first few days after an operation.

Your child should be easy to wake up

If your child takes an opioid, it may make him sleepy. But it should be easy to wake him up. If you have trouble waking your child, call your doctor or go to the emergency department right away.

Going to the bathroom

If your child takes an opioid for a few days, he may find it hard to have a bowel movement (have a poop). This is called constipation. To avoid constipation, try to get your child to drink lots of fluids, such as water, juice, and milk. Eating fruits and vegetables, especially raw ones such as apples, pears, oranges, carrots, and celery, will also help. Lots of fluid and these foods will often make it easier for your child to have a bowel movement.

Your surgeon may sometimes prescribe medicine to help your child have a bowel movement.

Opioids and acetaminophen

You can give your child opioids and acetaminophen together if he is having a medium amount of pain in the first few days after the operation.

For a younger child that is having a medium amount of pain, you can give him liquid opioid, as well as liquid acetaminophen.

For an older child, you can give a combination pill that contains both an opioid and acetaminophen.

Different medicines for different pain

What pain medicines your child should get depends on how much pain your child has. For example:

  • Mild pain: Give acetaminophen. This medicine is also called Tylenol®, or Tempra. Give only 1 of these 3 same medicines to your child.
  • Medium pain: Give acetaminophen plus an opioid to your child.
  • Strong pain: Call the hospital or your doctor.

Other pain medicines

The nurse, advanced practice nurse, or doctor may give you other pain medicines for your child, to use at home. Ask how and when to use this other medicine if the doctor prescribes it for your child. The nurse, advanced practice nurse, or doctor may tell you that you can use the other medicine by itself, or together with acetaminophen.

If this medicine does not help your child, ask your advanced practice nurse, doctor, or family doctor for advice.

Please fill in the information below, or ask your nurse or advanced practice nurse to help you before you leave the hospital.

The pain medicine for my child is:

1. Name of pain medicine:

How much to give (dose):

How often to give:

2. Name of pain medicine:

How much to give (dose):

How often to give:

3. Name of pain medicine:

How much to give (dose):

How often to give:

Your child's safety and pain medicine

Using pain medicine is a safe way to lessen your child's pain in the first few days after an operation. There is no danger that your child will need more and more medicine to not feel pain if you give it to him in the first few days after the operation. There is no danger that your child will need the medicine after the pain goes away. Most children need pain medicine for a few days or even a week after the operation.

In a few days, when your child is in less pain, you can just give your child regular acetaminophen for mild pain.

Lessening pain without medicine

Comfort your child in the ways that worked best for him before the operation. Hold, cuddle, rock, or stroke him. Give an older child a back rub, or encourage him to listen to music or practice breathing and blowing.

Distraction takes away pain

Take your child's attention away from his pain. Some children are distracted by:

  • watching TV, videos, DVDs, or computer games
  • storytelling
  • blowing bubbles
  • playing with you
  • playing with their favorite toy

Finding out how your child is doing

After you try to help your child feel less pain, you need to check and see if his pain is really less than it was before.

Here is how you can check:

  • Check how much pain your child has 1 hour after you give the pain medicine.
  • Ask your child about the pain on the scale from 0 to 10, or "hurts a little, hurts a lot", or look carefully at how he acts.
  • If your child is still in pain, call your doctor or the unit your child was on to see if you are giving him the right amount of medicine.
  • Ask if the nurse, advanced practice nurse, or doctor can suggest a stronger medicine for your child's pain.
  • Remember to comfort your child and try to take his attention away from the pain.

There is a chart that comes with this brochure:  Pain Diary: Pain After an Operation.

You can put the chart on your fridge. You can use it to keep track of your child's pain and to make a note of what helped him, or her. It can also be useful if you need to talk to a doctor, advanced practice nurse, or nurse about your child's pain, or the amount of medicine you have been giving your child.

If the pain medicine and comforting your child do not work to lessen pain or if your child's pain gets worse, call your doctor's office.

Write down your doctor's name:

Write down your doctor's number:

Janet Ahier, APN

Kimberly Colapinto, RN, BScN, MN

Jo-Anne Marcuz, MScPT

Basem Naser, MBBS, FRCPC

4/9/2012




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