After heart surgery, your child will likely experience some pain. Here are ways to assess and control your child's pain after surgery.
How do you know if your child is in pain?
Sometimes your child will say when they hurt. They may use words like pain, hurt, booboo, sore, or ouchie. Your child may point to the part that hurts, or protect it. If they don’t complain of pain, you can ask your child how much pain they have.
If your child is older, the nurses 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. 0 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.
What if your child doesn’t tell you about their pain?
Your child may not be able to talk or tell you about his or her pain. Watch your child carefully and see what you think. Parents often know if their child has pain.
What if you still don’t know if your child is in pain?
Look and see if your child frowns, or kicks out their legs. Do they grind their teeth? Does your child pull their legs up to her stomach? If they moan or cry more than usual, or are stiff, your child may have pain.
What can you do when your child is in pain?
Before you leave the hospital with your child, the doctor or nurse will tell you how you can help your child when they hurt. Normally, if your child is in pain on the day they go home, you can give them 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 them hurt less.
How soon should you give pain medicine to your child?
Don’t wait until your child is in a lot of pain before you give the medicine. 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 they need it. You will know that your child needs the medicine when they say it hurts. The way they act may also show you that your child is in pain.
What pain medicine should you use?
Acetaminophen
If your child is having mild pain, you can use regular acetaminophen (Tylenol or Tempra) 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 (dose) for your child’s age and weight.
Acetaminophen is a safe medication 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.
Ibuprofen
Ibuprofen (Advil or Motrin) is an anti-inflammatory medication which may be prescribed for your child at home. It can be given for mild to moderate pain. The appropriate dose and timing will be prescribed for your child at the time of discharge.
Morphine
You can give your child morphine if they are having a medium amount of pain at home. Which you use will depend on what worked well in hospital and was prescribed for your child at discharge.
You can give morphine every 4 to 6 hours. 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 or nurse to tell you the correct amount to give.
Morphine is a safe medication to give your child in the first few days after the operation.
What should you do if your child is too sleepy?
If your child takes morphine, it may make them sleepy. They should be easy to wake up. Check your child occasionally to make sure they are breathing regularly. If you have trouble waking your child, call your doctor or the emergency department immediately.
What should you do if your child cannot have a bowel movement?
If your child takes morphine for a few days they may find it hard to have a bowel movement (have a poop). Not being able to have a bowel movement is called constipation. Try to get your child to drink lots of fluids, such as water, juice, and milk. Try to have them eat fruit and vegetables, especially raw ones such as apples, pears, oranges, carrots, and celery. These foods will often help your child to have a bowel movement.
What kind of medicine should you give for mild, medium, or strong pain?
- Mild pain: Give acetaminophen to your child.
- Medium pain: Give ibuprofen to your child. You may also need to give morphine.
- Strong pain: Call the hospital or your doctor
Will your child get too used to taking pain medication?
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 them 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 will not need to give them codeine or morphine. Then, you can give your child regular acetaminophen for mild pain.
How can you comfort your child?
Comfort your child in the ways that worked best for them before the operation. Hold, cuddle, rock, or stroke them. Give an older child a back rub, or encourage them to listen to music or practice breathing and blowing. Take your child’s attention away from their pain. Some children are distracted by:
- watching TV or videos
- storytelling
- blowing bubbles
- playing with you
- playing with their favourite toy
How is your child doing?
After you try to help your child feel less pain, you need to check and see if their pain is really less that it was before. How can you do this?
- One hour after you give the pain medicine, check how much pain your child has.
- Ask your child about the pain on the scale from 0 to 10, or look carefully at how they act.
- If your child is still in pain, call your family doctor or the unit your child was on to see if you are giving them the right amount of medicine.
- You may ask if the nurse or doctor can suggest a stronger medication for your child’s pain.
- Remember to comfort your child and try and take their attention away from the pain.
If the pain medicine and the comforting action you are taking do not work to lessen your child’s pain, call the hospital. You may also call your child’s family doctor.
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