Dr A R Lloyd-Thomas MB BS FFARCSConsultant Paediatric Anaesthetist |
Pain should always be anticipated and discussed with your child in age appropriate terms. For most ENT operations powerful morphine like painkillers will be given and these are often combined with paracetamol and diclofenac.
Most operations will not require an overnight stay, so you will need painkillers at home. Look below to get advice on the correct medication for your child's surgery:
Painkillers for your ENT Operation |
Pain can be well controlled if medication is given on a regular basis, you should not worry about giving these simple painkillers regularly; they will help your child's recovery from their operation.
Advice is available from The Portland Hospital (0171 580 4400) or your General Practitioner.
Examining the ears, making the cut in the eardrum and putting in the grommet are painful, which is why an anaesthetic is needed. After that they are not usually very painful, but if the ear canal has had to be slightly stretched to get the grommet in there may be some ache in the ear. Some children find the loudness of their improved hearing to be painful. Paracetamol and voltarol will have been given during the anaesthetic so no further pain killers should be given until 6 hours have passed.
Once you are at home and six hours have passed since the anaesthetic, futher paracetamol (Calpol) and ibuprofen (Childrens' Neurofen) may be given. Both medicines may be given as they work by different mechanisms. ALWAYS follow the instructions on the bottle and DO NOT exceed the maximum dose for your child.
Adenoidectomy is painful, like having a sore throat. Fentanyl (a morphine like pain killer), voltarol and paracetamol will have been given as part of the anaesthetic.
Once you are at home and six hours have passed since the anaesthetic, futher paracetamol (Calpol) and ibuprofen (Junifen) should be given. Both medicines may be given as they work by different mechanisms. Children should be given both these medicines regularly for the first 48 hours following the operation, according to the instructions on the side of the bottle. After 48 hours have passed only give these medicines if you think your child needs them. After this operation, most children will have stopped painkillers althogether, within 48 hours.
ALWAYS follow the instructions on the bottle and DO NOT exceed the maximum dose for your child.
Follow this summary table:
Day Paracetamol
(Calpol)Diclofenac
(Voltarol)Ibuprofen
(Neurofen or Junifen)Codeine
(Linctus or Tablets)Operation Day Yes
Six hours AFTER the anaestheticNo Yes
Six hours AFTER the anaestheticNo Day 1 and 2 Yes, give regularly every six hours No Yes, give regularly every 8 hours No Day 3 onwards Only if required No On;y if required No You can get further advice from the Portland Hospital (020- 7580 4400)
Adeno-tonsillectomy is painful, like having a bad sore throat. Fentanyl (a morphine like pain killer), voltarol and paracetamol will have been given as part of the anaesthetic. Further doses will have been prescribed and will be given by the nurses. Before the next doses are due, if required, codeine elixir may be given.
The following day when you go home, you will be given the following medications:
Days 1-5:
Voltarol suppositories (approx. 1 mg/kg 8 hourly)
Paracetamol (approx 20 mg/kg 6 hourly)
Codeine elixir (approx 1 mg/kg 8 hourly as required)
Days 5-10:
Ibuprofen (approx 5mg/kg 8 hourly)
Paracetamol (approx 20 mg/kg 6 hourly)
These should be given regularly for the period prescribed.
ALWAYS follow the instructions on the bottle and DO NOT exceed the maximum dose for your child.
Follow this summary table:
Day Paracetamol
(Calpol)Voltarol
(Diclofenac)Ibuprofen
(Neurofen/Junifen)Codeine
(Linctus or Tablets)Operation Day Yes
Will be given by the nursesYes
Will be given by the nursesNo Yes
Will be given by nurses if requiredDay 1 to 5
(inclusive)Yes
Give every six hoursYes
Give every 8 hoursNo Yes
Give if required every 8 hoursDay 6 to 10
(inclusive)Yes
Give every six hoursNo
Not more than five daysYes
Give every six hoursMay be given if required every 8 hours You can get further advice from the Portland Hospital (020- 7580 4400)
If you child appears to have an undue amount of pain please get advice from your General Practitioner or Mr Albert .
Pain should always be anticipated and discussed with your child in age appropriate terms. For most urology operations powerful morphine like painkillers will be given and these are often combined with local anaesthetic blocks (like the dentist 'freezing' your jaw before undertaking a dental operation). I will discuss pain relief when we meet in hospital.
Major operations will involve a sufficient stay in hospital to allow almost complete recovery and minimal pain by the time of discharge.
More minor operations will not even require an overnight stay, so you will need painkillers at home. Look below to get advice on the correct medication for your child's surgery:
Painkillers for your Urology Operation |
|
Laparoscopy |
|
Repair of Fistula Meatoplasty |
|
|
|
|
|
|
Pain can be well controlled if medication is given on a regular basis, you should not worry about giving these simple painkillers regularly; they will help your child's recovery from their operation.
Advice is available from The Portland Hospital (0171 580 4400) or your General Practitioner.
Circumcision- what to do at home:
The initial pain is well controlled by an epidural block, but this will only last for 6-10 hours. Once this has worn off the penis will be painful, especially when passing urine. The pain is much more distressing in the older child (>3 years).
The following medication should be used on a REGULAR basis, started BEFORE the epidural block has worn off, but NOT commenced until at least four hours have passed after the end of the child's anaesthetic, unless advised by the nurses on the ward.
Paracetamol (e.g. Calpol)- give regularly every six hours according to the instructions on the bottle.
Ibuprofen (e.g. Childrens' Neurofen)- give regularly every eight hours according to the instructions on the bottle.
Codeine Elixir- this is 'rescue' pain relief, to be given if required no more frequently than every eight hours, according to the instructions on the bottle. This is a prescription only medication and will be dispensed as a take home medicine on discharge.
This medication will be required on a REGULAR basis for 48 hours, after which you should give painkillers only if required.
ALWAYS follow the instructions on the bottle and DO NOT exceed the maximum dose for your child.
If you have problems with pain control, contact the Portland Hospital (0171 580 4400) or your General Practitioner.
Repair of Hernia/Hydrocoele: what to do at home:
The initial pain is well controlled by the ilioinguinal/iliohypogastric nerve block, but this will only last for 6-10 hours. Once this has worn off the groin will be painful.
The following medication should be used on a REGULAR basis, started BEFORE the nerve block has worn off, but NOT commenced until at least four hours have passed after the end of the child's anaesthetic, unless advised by the nurses on the ward.
Paracetamol (e.g. Calpol)- give regularly every six hours according to the instructions on the bottle.
Ibuprofen (e.g. Childrens' Neurofen)- give regularly every eight hours according to the instructions on the bottle.
Codeine Elixir- this is 'rescue' pain relief, to be given if required, no more frequently than every eight hours, according to the instructions on the bottle. This is a prescription only medication and will be dispensed as a take home medicine on discharge.
This medication will be required on a REGULAR basis for 24 hours, after which you should give painkillers only if required.
ALWAYS follow the instructions on the bottle and DO NOT exceed the maximum dose for your child.
If you have problems with pain control, contact the Portland Hospital (0171 580 4400) or your General Practitioner.
Orchidopexy- what to do at home:
The initial pain is reasonably well controlled by the ilioinguinal/iliohypogastric nerve block, but sometimes the incision in the scrotum can be painful. The block will only last for 6-10 hours, once this has worn off both the groin and the scrotum will be painful. The degree of pain your child will experience after an orchidopexy varies with the distance that the testicle has to be moved in order to site it correctly in the scrotum; the further that it has to be brought down, the more painful it is. You should also note that this operation frequently makes children feel nauseated, they may even vomit; fluids should be started with caution.
The following medication should be used on a REGULAR basis, started BEFORE the nerve block has worn off, but NOT commenced until at least four hours have passed after the end of the child's anaesthetic, unless advised by the nurses on the ward.
Paracetamol (e.g. Calpol)- give regularly every six hours according to the instructions on the bottle.
Ibuprofen (e.g. Childrens' Neurofen)- give regularly every eight hours according to the instructions on the bottle.
Codeine Elixir- give regularly, according to the instructions on the bottle,every eight hours for 24 hours. Thereafter, use this as 'rescue' pain relief, to be given if required, no more frequently than every eight hours, according to the instructions on the bottle. This is a prescription only medication and will be dispensed as a take home medicine on discharge.
This medication will be required on a REGULAR basis for 72 hours, after which you should give painkillers only if required.
ALWAYS follow the instructions on the bottle and DO NOT exceed the maximum dose for your child.
If you have problems with pain control, contact the Portland Hospital (0171 580 4400) or your General Practitioner.
The initial pain is well controlled by an epidural block, but this will only last for 6-10 hours. Once this has worn off the penis will be painful. The pain is much more distressing in the older child (>3 years). There will be a bladder catheter, either a 'dripping' stent if the infant wears nappies or a full catheter in the older child. The presence of these tubes can cause the bladder to contract ('bladder spasms') and many children find this more distressing than any discomfort from the penis. Bladder spasms can be reduced by oxybutinin, a medicine which relaxes the bladder muscle; Mr Duffy will prescribe this if it is likely to be required.
For pain relief, the following medication should be used on a REGULAR basis. These medicines (or something similar) will have been started during the anaesthetic and continued on the ward, BEFORE the epidural block has worn off. When you are ready to go home they will be dispensed for you to continue at home:
Paracetamol (e.g. Calpol)- give regularly every six hours according to the instructions on the bottle.
Ibuprofen (e.g. Childrens' Neurofen)- give regularly every eight hours according to the instructions on the bottle.
Codeine Elixir- this is 'rescue' pain relief, to be given if required no more frequently than every eight hours, according to the instructions on the bottle. This is a prescription only medication and will be dispensed as a take home medicine on discharge.
This medication will be required on a REGULAR basis for 4-5 days, after which you should give painkillers only if required.
ALWAYS follow the instructions on the bottle and DO NOT exceed the maximum dose for your child.
If you have problems with pain control, contact the Portland Hospital (0171 580 4400) or your General Practitioner.