Children and surgery pain

Pain after surgery is common. It is also normal. Steps can be taken to minimize or eliminate pain, but pain that gets worse, especially with other symptoms, can be a sign of a surgical complication that may need to be checked out by the doctor.

Children who have surgery experience pain just as adults do, and they are usually able to express their pain in one form or another. Most children older than 18 months can use the word "pain," and children younger than 18 months often say they are"hurt" or they have a "boo-boo."

However, children often have a hard time explaining how much pain they feel. In addition, very young children who cannot speak have a more difficult time communicating how much pain they feel. Consequently, the parent must watch the child for nonverbal signs of pain that may include the following:

  • Crying
  • Poor feeding
  • Poor eating
  • Poor drinking
  • Lethargy
  • Sleeplessness
  • Unhappy facial expressions
  • Irritability 
  • Clinginess
  • Fussiness

The parent should note how the child is behaving compared to his or her usual behavior and tell the doctor. The doctor may use pictures that the child can choose from to indicate where the child feels pain and how much pain he or she feels. A happy, playful child who is sleeping and eating well is rarely in pain.

Just as children express pain differently, pain management in children can also vary. Dosages and availability of pain medications are different for children. With children, dosages are often calculated by weight. Therefore, knowing the child’s weight is important.

Children may also be influenced by other factors. For example, a child may have a strong fear of the surgical procedure that may last even after the surgery, or the child may believe the pain of surgery is a punishment for something.  Talking to the child about his feelings and explaining clearly what is going to happen and why, both before and after the surgery, are important. It also allows the child to ask questions and talk about his or her fears.

Having a plan for managing a child’s pain after surgery is important. Discuss the type of medication, dosages, and timing of medications with the child’s doctor. Also, discuss what other treatments and instruction will minimize pain and anxiety after surgery.