I am sending this to you from the children’s hospital where our three year old just had hip surgery. The nurses keep pushing drugs into this kid to “keep him comfortable” — is it really a good idea to put young children on narcotics like this? How do they even know he’s having any pain when he’s so drugged up? I’m really concerned.

It is a tough sell but patients undergoing surgery for any reason must take their pain medications as prescribed. That means the full amount as often as recommended. Many Americans still subscribe to the belief that if there’s “no pain, there’s no gain”. And they feel it is better to “tough it out” rather than take drugs.

But the truth is — research shows that uncontrolled pain turns on systems in the body that result in delayed or impaired healing. In addition, there are more complications in general, breathing problems, and the risk of death is much higher.

All of these concepts also apply to children. In the pediatric post-operative group, pain increases the child’s stress. Stress hormones increase tissue metabolism and that leads to negative effects on healing. The result is that besides pain, the child ends up with a longer hospital stay, which adds more stress and keeps the cycle of impaired healing going.

Most surgical teams and postoperative hospital staff take the task of pain control among children very seriously. They may even have a team dedicated to this job. The first step is family and patient education. Everyone involved with the child’s case must understand the importance of pain control and the consequences of inadequate pain management. The surgeon, anesthesiologist, and nursing staff help parents, family members, and care givers of children understand how the pediatric body responds to pain.

From the youngest baby to the oldest child, decisions about medications for pain control are based on several individual factors. Body weight is important because the water content affects how drugs bind with proteins in the blood. Age and size determine the water-to- protein ratio and thus the amount of drug to use (e.g., anesthesia during surgery, narcotics for pain control after surgery).

There are strict guidelines for the use of pain relievers. It may seem like the nursing staff is “pushing drugs” to keep the child comfortable. But it is likely that the specifc drug and drug dosage (how much is given and how often it is administered) is carefully determined.

Nurses can monitor the child’s pain response by taking vital signs (blood pressure and pulse are especially helpful tools for assessing pain). In older children, questions can be asked about pain. A visual tool is often used with hand drawn pictures of a face with different expressions to choose from as a means of determining the child’s level of pain.

Pain control and drug usage is serious business and must be approached that way in each and every case. If you have serious concerns about what your child is being given, don’t hesitate to contact your surgeon, the child’s pediatrician, or even the physician serving as the hospitalist (if the facility has one). Your concerns and questions are important. A calm, confident parent is a necessary ingredient in a child’s recovery.