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Managing pain after an operation

Information for patients

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Paediatric Anaesthesia

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It is normal for children and young people to be a bit sore after an operation. This might be at the site of the operation, but they may also have a dry sore throat or a tender hand or foot from where their drip has been.

How do I know if my child is in pain?

Every child will cope with pain differently. Your child may tell you they are sore, but they may just become quiet or reluctant to play. If your child is finding it hard to describe how they are feeling, this simple scale may help.

pain scale numbered 0-10. with ) being no pain and 10 being the worst pain possible

How can I help them feel better?

Think of the simple things first!

  • Help them get into a comfy position
  • Try using hot water bottles for comfort or ice packs to ease swelling.
    Remember to wrap these in a towel so that the heat or cold does not burn the skin
  • If an arm or leg is uncomfortable it can help to elevate it on some pillows
  • Distraction works really well – story books, colouring, video games or the TV!
  • Help them to relax – calm music, cuddles or just telling them that you are there and that they will feel better soon really helps.
  • Then give them pain medicines. There is more information about this below

Pain medicines

Pain medicines work best when different medicines are given together, at set times. The two most common medicines used with children are Paracetamol and Ibuprofen.

For the first few days after an operation, we advise giving the medicine at mealtimes and then another dose at bedtime.

It is safe to give Paracetamol and Ibuprofen together.

When your child starts to feel better, you can give the medicines just when needed.

Paracetamol (Calpol, Medinol, Disprol)

  • This is used for pain and it also helps to reduce a temperature (fever)
  • It can be taken every 4 to 6 hours but do not give more than four doses in a 24 hour period
  • Paracetamol rarely has any side effects.

Ibuprofen (Nurofen, Junifen)

  • This is used for pain and can also be used to reduce a temperature (fever).
  • It can be taken every 4 to 6 hours but do not give more than four doses in a 24 hour period.
  • Ibuprofen can sometimes cause an upset tummy so is best given with food. It can also make some children with asthma a bit wheezy. If your child gets wheezy, you should stop giving the Ibuprofen and contact the hospital.

Stronger pain medicines

After some operations the hospital may give you a stronger pain medicine for your child. This is usually a medicine called Oral Morphine Solution (Oramorph). This should be given only if your child is still sore after having taken their other pain medicines.

Sometimes oral morphine can make children sleepy or feel a bit sick. If you notice that your child is very sleepy or breathing slowly after they have taken oral morphine, you should not give any more medicine and contact the hospital.

Once your child is feeling better, do not keep stronger pain killers at home “just in case”. Please take unused medicine to the local pharmacy for disposal.

My child keeps spitting out their medicines

If your child keeps spitting out medicines you can buy flavoured Ibuprofen and Paracetamol from most supermarkets. You do not have to give the hospital ones. Just follow the instructions on the bottles.

What should I do if my child is still in pain after I’ve given the pain medicines?

  • Make sure you are giving your child their medicines regularly.
    Pain medicines work best if they are given this way. It can be helpful to set an alarm on your phone or write things down so you don’t forget what you have given (useful if you have to call the hospital), or when the next doses are due.

  • Make sure you are giving the correct dose.
    This is written on the bottle.

  • If the hospital have given you oral morphine for your child, this may help, but do not give more than four doses in a day. Do not give any other pain medicines that you may have at home, as they may be dangerous for your child to take.

Important

If you are still worried, contact the hospital, the local GP, urgent treatment centre, 111 or a pharmacist for advice.

How to give your child their pain medicines at home

Name:
Procedure:

Start by giving Paracetamol and Ibuprofen regularly and then reduce them as needed. Oral Morphine should not be given regularly unless we have advised you to do so.

I had my last doses of hospital medicine at…

Paracetamol:
Ibuprofen:
Oral Morphine:
Other:
MorningLunchtimeTeatimeBedtime
Paracetamol
Ibuprofen
Oral morphine
solution:



Maximum 4 doses in any 24 hour period. Leave at LEAST 4 hours between dose
Other advice:



Form completed by: (Name/NMC)
Date:

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The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW.
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