Sometimes we give oral Paracetamol before the surgery; most post-operative pain relief is given orally, unless your child has had surgery on their bowel.
Your child and pain relief
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Your child and pain relief
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Good pain relief is very important. Anaesthetists are skilled in a range of methods to treat pain. Your anaesthetist will decide with you what is most suitable for your child and the type of surgery planned. Pain relief can be given by various routes.
Pain relief options
We often give IV pain relief while your child is asleep, and post-operative pain relief may be given this way, especially early on. If your child is old enough, they may be given a PCA (Patient Controlled Analgesia) pump which allows them to control their own pain relief. When they press the button, the machine delivers a set amount of drug, usually Morphine, into their vein. The anaesthetist sets limits on the machine, so they cannot overdose themselves. In younger children, the nursing staff will manage a pain pump.
Local anaesthetic is used to numb the operation site. It is injected while your child is asleep, but is still working for several hours afterwards.
Local anaesthetic is injected around a nerve supplying a region of the body using an ultrasound scan to locate the site. E.g. for groin surgery we can numb the nerves in the abdominal wall muscles which supply the groin. It is very rare for an anaesthetist to damage nerves when placing a nerve block. This sort of local anaesthetic lasts for many hours afterwards.
This is an injection by your child's tail bone, which numbs them from the waist down. It is given at the very bottom of the spine, below where the spinal cord is found. It is often used for painful surgery involving the groin or legs. It is done while your child is asleep. It numbs the pain nerves, but also numbs other nerves, so your child will initially have weak legs and be uncoordinated when they try and walk. These effects all resolve by the next day, although very few children can still be a bit clumsy on their legs the next morning. All effects should have gone by two days later.
Risks
Caudals are generally very reliable, and low risk.
This is similar to an epidural for childbirth. It is commonly used for major hip surgery. While your child is asleep we will position them, place a needle in their back in to the epidural space (outside of where the spinal cord is found), and then pass a very narrow plastic tube through the needle. We then take the needle away, and attach the plastic tube to their back to stop it being dislodged. We can run an infusion of local anaesthetic through this tube for a couple of days, to keep them comfortable.
Risks
Risks include failure, dislodgement, headache, infection and nerve damage. Your anaesthetist will discuss these more with you.