Managing pain in children who have had an operation

Weekdays 7: 00 am to 7:30 pm:

Paediatric Day Unit: 0300 422 8452 / 8453

Weekends and after 7:30 pm:

GRH Paediatric Ward Co-ordinator:

Call 0300 422 2222 and ask for bleep 2425

Following Eye surgery

Cheltenham Eye Casualty: 0300 422 3578

Will my child be in pain after the operation?

There is often some pain or discomfort in the first few days after an operation. The amount of pain will depend on the type of surgery your child has had.

Your child may have been given a local anaesthetic or other pain-relieving medicines during the operation. This pain relief will work for some time afterwards.

Pain relieving medicines

To keep you child comfortable, it is important that you continue to give your child regular pain-relieving medicine once you go home. This is especially important if your child has had a local anaesthetic injection as this can wear off suddenly.

Paracetamol and ibuprofen can be given together as they work in different ways. Pain-relieving medication should be given regularly for the first 2 to 3 days following the operation. After this, you can give the medication when needed.

The doses stated on this page are for post-operative pain (not coughs or colds) they may therefore differ from the dosage instructions on the medication bottles.

If your child has had an operation which can cause severe pain, you may be given stronger pain relief such as Codeine or Oral morphine to take home.

• Paracetamol (Calpol®): Dose after surgery is 15 mg/kg four times a day.

• Ibuprofen: Dose after surgery is 7.5 mg/kg four times a day. Give this medication with a meal or snack.

Do not give Ibuprofen if:

• • your child is less than 3 months old,
  • weighs under 5 kg
  • has severe asthma, heart, kidney, or liver problems.
• Codeine phosphate (for children over 12 years old): Dose is 30 to 60 mg four times a day for a maximum of 3 days.
• Oral morphine: This medication is for the treatment of severe pain only and should be taken for the shortest time possible. You will be given clear dosage instructions if your child is discharged with morphine.

Pain after tonsillectomy

A sore throat and earache can last about 7 to 10 days after a tonsillectomy, the pain can peak at around 5 to

7 days. It is important to give your child regular pain-relief especially about half an hour before eating. This is so that your child will be able to eat and drink comfortably.

It is important that your child drinks plenty of fluids to avoid becoming dehydrated. They should also be given foods that are a bit crunchy as this will help to clean the slough (dead tissue) from the back of the throat and help stop the tissue from becoming infected.

Other methods of pain relief

Other techniques can be used alongside regular pain-relieving medicine. These can help lessen your child’s anxiety and stress which, in turn, has been proven to reduce pain.

Distraction

Help your child to concentrate on something such as a game, TV, books, or a DVD.

Relaxation, massage, and touch

Deep breathing and gentle massage can help your child to relax and be more comfortable.

Other simple ways to help relieve your child’s pain include lots of rest, sleep and keeping your child warm and comfortable.

Advice once you are home

If your child’s pain is very severe, despite pain relief, or your child is being sick and not keeping any medicine down, please seek advice as per the instructions at the start of this page.

Please use the table the below to record the date/time when your child has been given the medication. Take your leaflet with you if you re-attend the hospital.

Please note that paracetamol and ibuprofen can be given at the same time as they work in different ways.

Pain relief

See the NHS website for advice on pain relief for babies and children: https://www.nhs.uk/conditions/baby/health/medicines-for-babies-and-children

We recommend that you record the date/time when your child has been given medication and take this with you if you re-attend the hospital.