Acute Pain Management Service

Here at Children’s Nebraska, we recognize and honor the unique pain experience that each child faces. We treat each child and condition individually and include the patient’s family in our approach to managing pain. We cover all ages of children using a variety of methods for pain management.

We believe it is important to anticipate pain and formulate a plan to alleviate it. Uncontrolled pain can slow post-operative healing and lead to helplessness, which diminishes the child’s ability to participate in everyday normal activities.

Additionally, under-treated acute pain can progress to chronic, ongoing pain.

Our mission is the successful management of acute pain and pain medication side effects in postoperative children.

Side effects of pain medications can include:

  • Nausea
  • Itching
  • Constipation
  • Sedation
  • Respiratory issues

These are also addressed on an ongoing basis to help make the patient as comfortable as possible.

“The pediatric population is at risk of inadequate pain management, with age-related factors affecting pain management in children.”

–American Medical Association (June 2013, Module 6 Pediatric Pain Management)

Who We Cover

We assist in providing care to hospitalized postoperative patients who have undergone a moderate to severely painful procedure.

Surgical procedures we often help care for postoperatively include:

  • Major orthopedic surgeries
  • Urologic procedures
  • Thoracic
  • Cardiac procedures
  • Major abdominal procedures

Children in our care vary in age from premature infants to adolescents. All developmental levels and special needs are considered.

Methods of Pain Management

We offer a variety of methods for pain management, including:

  • Epidural infusions or patient-controlled epidural infusions (PCEA)

    Epidural this form of pain management involves a small tube inserted in the epidural space. It can be very effective at “bathing” nerves in the area where a child’s operation took place.
  • Patient-controlled IV medications (PCA)

    The PCA form of pain management gives the patient some control. A secure, locked machine allows the patient to push for a safe number of medication doses.  Based on the child’s weight, safety is built in so no child can over-medicate themselves.
  • Peripheral nerve blocks

    Nerve Block is performed by a trained anesthesiologist using ultrasound equipment.  A local anesthetic medication is injected to “block” pain messages in limbs that have undergone a painful procedure (such as knee surgery).
  • Nurse-controlled IV and oral medications

    IV or oral (by mouth) pain medications are also available.

A child’s developmental level, as well as the surgical procedure, help guide us to the best method. All children are safely monitored and methods of pain management are adjusted when needed.

Our ultimate goal is to transition each child to oral (or gastrostomy button) medications that they will be continuing at home for pain management. This gives us the opportunity to observe the child’s response to these home medications and make adjustments while they are still in our care.

Interdisciplinary Pain Committee

Children’s Nebraska’s Interdisciplinary Pain Committee consists of a core group of anesthesiologists, intensivists (neonatal and pediatric ICU physicians), pharmacists, physical therapists, hematologist/oncologists, rheumatologists, RNs, parents, and child life specialists who are passionate about improving acute and chronic pain strategies in all children through clinical work, education, and research meet monthly to discuss the best practices for management of pediatric pain.


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