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Alle barn som har gjennomgått en operasjon, får regelmessig smertelindring så lenge det er behov.

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Dette starter i en tidlig fase, ofte til og med før det kirurgiske inngrepet. Dette gjøres for å bygge opp et smertelindringsnivå i blodet, som betyr at kroppens egen reaksjon på smerte reduseres. Dette gir ofte et mindre behov for smertelindring. For å opprettholde jevne konsentrasjoner av et legemiddel i blodet – for å oppnå optimal effekt og unngå «smertetopper» – vil barnet også regelmessig få smertelindring, selv om det ikke ser ut til å ha smerter akkurat da. Ved å gi regelmessig smertelindring og forebygge smerteoppblussing, kan man ofte redusere mengden medikamenter som gis. Dette reduserer også risikoen for bivirkninger, slik som forstoppelse og kvalme.

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For å oppnå best mulig resultat med smertehåndteringen brukes det ofte en kombinasjon av medikamenter som virker på forskjellige måter og ulike måter å administrere disse på. Hvordan medikamentene gis, avhenger av inngrepet som skal gjøres, hvordan barnet føler seg og hva som passer best for barnet i den aktuelle situasjonen.

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Det er vanlig å gi smertelindring intravenøst direkte inn i blodstrømmen. I disse tilfellene kan medikamentet administreres både som injeksjonereller som kontinuerlige dryppvia en medisinpumpe. Smertelindring kan også gis oralt som tablettereller i væskeform.

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Smertelindring med etlokalbedøvelsesmiddelbetyr at medikamentet påføres eller injiseres under huden som individuelle eller gjentatte doser eller via dråper. Lokalbedøvelsesmidler hindrer smerteoverføring i nervene i området der medikamentet brukes. Den lokalbedøvende salven som smøres på barnet før kanylen settes inn, er en form for lokalbedøvelsesmiddel.

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Når det gjelder smertelindring ved hjelp av en nerveblokade, injiseres det et lokalbedøvelsesmiddel rundt en nerve for å hindre eller blokkere signalene gjennom nervebanen. En nerveblokade kan gis både som en enkeltbehandling eller ved å føre inn en tynn slange der medikamentet administreres under og etter operasjonen.

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Epidural smertelindringer et eksempel på en nerveblokade der et barn i narkose har et tynt rør ført inn i ryggen. Når det brukes epidural smertelindring, kan anestesimiddelet påvirke blæren i mange tilfeller, noe som betyr at barnet ikke er klar over når det må urinere. I de fleste tilfeller vil barnet også ha et urinkateter. Dette er et rør som kan bety at barnet føler et behov for å late vannet selv om blæren er tom. Epidural smertelindring kan også påvirke styrken og følelsen i bena. Det er viktig at man forteller barnet om dette og at det tynne plastrøret ikke vil hindre bevegelser eller gjøre det vanskelig å ligge på ryggen i sengen.

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Morfin brukes ofte som smertelindring ved mer omfattende kirurgiske inngrep eller skader. Det skapes ikke avhengighet når morfinen brukes til smertelindring. Hvis barnet har fått morfindoser i en lengre periode, vil dosen gradvis bli redusert for å unngå smerteoppblussinger og abstinenssymptomer.

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You are a really helpful support for your child. It is important that you feel well informed and secure about the situation. At the Anaesthesia Web, you can prepare for your child’s hospital visit.

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För att du ska kunna hjälpa och stödja ditt barn är det viktigt att du som närstående själv känner dig välinformerad och trygg med situationen. På Narkoswebben får du hjälp att förbereda dig inför ditt barns sjukhusbesök.

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