Pain relief after heart surgery

This page explains about pain relief after heart surgery and what to expect when your child comes to Great Ormond Street Hospital (GOSH).

Your child will need pain relief after they have left hospital following heart surgery. Great Ormond Street Hospital does not routinely prescribe paracetamol or ibuprofen to take home, as these can be easily purchased from your local pharmacy.

Some of them are medicines that you may have previously given at home, but following surgery or similar procedures, you will need to give these more regularly or at different times.

Paracetamol

Paracetamol is a medicine for pain relief, suitable for mild to moderate pain. It is also used to reduce a fever. It is available as a generic (non-branded) medicine as well as brands including: Calpol©, Panadol©, Medinol©, Disprol© (dispersible), and Tylenol© (USA).

Paracetamol is available as an oral liquid, tablets and dispersible tablets. It is very safe and effective when administered correctly, but can lead to liver damage following an overdose. Paracetamol is not addictive and it does not cause drowsiness.

Paracetamol becomes effective about 30 minutes after it is given and lasts for around four to six hours.

Initially you should give paracetamol to your child regularly every four to six hours, particularly before bed, so that pain will not stop them from sleeping, and first thing in the morning, so that any stiffness or discomfort from lack of movement is eased. Suggested timing for regular doses are breakfast time, lunch time, tea time and bedtime.

The times and frequency can be adjusted to suit you and your family’s lifestyle and your child’s needs. Remember that four doses are the maximum number you should give in any 24 hour period.

If paracetamol is dispensed from GOSH, the dose of paracetamol on the pharmacy label may be slightly higher to the doses written on the bottle, because we have worked out the dose based on your child’s weight.

Ibuprofen

Ibuprofen is another pain relief medicine or analgesic, which belongs to the group called non-steroidal anti-inflammatory medicines. It is also used to reduce fever. It is available as a generic (non-branded) medicine as well as brands including: Nurofen© Fenpaed© Cuprofen© and Advil©. Ibuprofen comes as tablets, syrup, and dispersible granules.

Ibuprofen carries a small risk of causing stomach problems, such as a peptic ulcer or bleeding in the stomach. It is advisable to always give ibuprofen with or after food or milk. In a small proportion of people with asthma, ibuprofen may increase the symptoms of asthma, so should be avoided in severe or uncontrolled asthma.

Ibuprofen is not addictive and does not cause drowsiness.

Ibuprofen becomes effective about 30 minutes after it is given and lasts for around six to eight hours. You should give ibuprofen to your child regularly every six to eight hours, particularly before bed, so that pain will not stop them from sleeping, and first thing in the morning, so that any stiffness or discomfort from lack of movement is eased. Suggested timing for regular doses are morning, afternoon and bedtime.

Remember that three doses are the maximum number you should give in any 24 hour period.

Ibuprofen can be given at the same time as paracetamol, but it is advisable to stagger the doses to provide consistent pain relief for your child throughout the day.

If ibuprofen is dispensed from GOSH, the dose on the pharmacy label may be slightly higher to the doses on the side of the bottle. This is because we have worked out the dose based on your child’s weight. It usually works out to be slightly more than what is recommended on the side of the bottle but is safe.

Every child copes differently with pain, and pain relief should be aimed at meeting their individual needs.

Last reviewed by Great Ormond Street Hospital: May 2012
Ref: 2012F1212 May 2012
Compiled by the Cardiorespiratory and Pharmacy departments in collaboration with the Child and Family Information Group.