A New York City Police Department honorary surgeon, Brian Gilchrist, MD, has more than 30 years of experience as a pediatric surgeon, developing pediatric trauma systems in leading hospitals. A widely published medical researcher, Brian Gilchrist, MD, belongs to the American Pediatric Surgical Association (APSA) and serves on the association’s publications committee.
APSA is dedicated to saving lives by developing and sharing surgical standards and quality of care guidelines. It partnered with the American College of Surgeons to create resources to help parents caring for children who have undergone surgery. One of these is a guide on effective pain control.
Safe pain control entails using medication and other effective therapies to limit pain while having as few side effects as possible. After simple procedures, children can experience mild to moderate pain. After complex surgeries, children may experience severe pain. Parents can help in their children’s healing by monitoring them to identify signs of pain.
A child with mild pain does not exhibit signs of discomfort. The child notices the pain but he or she can still do normal activities like sitting up, standing, walking, and playing. With moderate pain, the child notices the pain and it interferes with his or her activities. The child may moan, squirm, or frown.
With severe pain, the child cannot engage in normal activities and finds it hard to sleep. The pain takes all of his or her focus. He or she has a rigid body, tenses or kicks his or her legs, and cries continuously.
For mild and moderate pain, doctors prescribe non-medication therapies (ice, rest, elevation, and physical therapy) and non-opioid oral medications (ibuprofen and acetaminophen). For severe pain, they can prescribe short-acting opioids on top of the above two. The opioids block pain receptors in the brain and spinal cord.
Parents whose children have been prescribed opioids should ensure their children take the lowest doses possible. In addition, they should never crush the pills or give them with antihistamines, sleep aids, muscle relaxers, and anti-anxiety medication.
Brian Gilchrist 