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Consequences of poor
pain management

How is pain
managed?

What parents can do



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Yale-New Haven
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(203) 688-4242

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(203) 688-4177

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(203) 688-2222

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Mailing address:

Yale-New Haven Hospital
20 York Street
New Haven, CT 06504

Reducing Pain from Surgery:

What a Parent Should Know

Many children suffer needlessly
The cry of a child in pain is heart wrenching to physicians and parents alike. In the past, many physicians were hesitant to use standard pain medications in children for fear the medications were too strong. Others believed the infant nervous system was too immature to feel pain. Today, we know that even premature infants feel pain, and evidence suggests that young infants may be more vulnerable to pain than adults. An estimated 1.5 million children have surgery each year in the United States and many of them receive inadequate pain relief.

Consequences of poor pain management in children

• Increased sensitivity to future painful exposures
• Altered temperament of the child
• Distrust of adults, physicians and other caregivers
• Longer recovery period after surgery and poor wound healing

Benefits of effective pain management

• Improved sense of well being and faster return to normal activities
• Decreased likelihood of complications and shorter hospital stay

How is pain managed?
Pain medications are called analgesics. Mild pain is handled with nonnarcotic analgesics like acetaminophen and ibuprofen. Mild to moderate pain is managed with weak narcotic analgesics such as codeine, while moderate to severe pain is managed with stronger narcotics such as morphine.

When pain medicines are taken for pain and not for pleasure, there is little risk of developing addiction. Administering inadequate doses, for fear of an addiction, is not sound practice and actually can lead to problems.

Pain medications should be given around-the-clock and children should not have to wait for pain to develop before medicine is given. Pain medications can be delivered by mouth, by intravenous catheter, through the skin or through special catheters placed in the epidural space or limb to treat an isolated area.

Anesthetic (numbing) creams and gels can be applied to the skin prior to skin puncturing procedures such as spinal taps, intravenous catheter placement and vaccinations. All types of pain management are available for children regardless of their age or size.

What parents can do
Find out if your hospital has standard pain management orders for children or an organized pediatric pain service. Discuss pain management with the physicians who will care for your child. Find out what will be available on a scheduled basis as well as an as needed basis. The first night of surgery often requires around-the-clock medicine.

Educating your child about what will happen before the surgery or procedure helps reduce anxiety and promotes cooperation in most cases. Your presence in the room during a procedure may be comforting to the child if you are calm. However, if you are asked to separate from your child, understand that your absence is considered best for your child in that particular situation.

When present, stay in physical contact with your child and distract him or her with conversation. For infants, stroking, cooing or a pacifier can be comforting. Ask if a numbing agent will be used and ask your doctor to make sure the agent is applied early enough to guarantee its effects before needle puncture.

Sedative medications may be needed in some cases and should be administered by an experienced physician. If sedation is used, make sure your child does not have milk or food for the time period suggested. This will make the sedation safer for your child.

Ask if procedures can be performed in a procedure room, instead of your child's hospital room, which should remain a safe haven.

Pediatric pain management
at Yale-New Haven Children's Hospital
The Pediatric Pain Management Service (PPMS) at Yale-New Haven Children's Hospital addresses pain-related issues for inpatients and outpatients 24 hours a day. The pain management physicians are Yale pediatric anesthesiologists with special interest, advanced certification and experience in pain management.

PPMS teaches physicians and nurses the latest in pain management advances and takes part in national and institutional studies on pain management in children.

Last revised: March 8, 2004 (cfs)

Home page URL: http://www.ynhh.org

All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.