Presbyterian Anesthesia Associates appreciates the opportunity to provide safe and gentle care for your child’s upcoming surgical procedure. We know that this is a stressful time and we want to answer your questions prior to your child’s scheduled surgery.
For elective surgery, the administration of a general anesthetic is similar to flying an airplane and is divided into three phases: A) take-off (induction or “going to sleep”); B) flying to a destination (the time during the actual surgical procedure); and C) landing (emergence from anesthesia in the recovery room). Each of these phases have specific safety concerns that are constantly monitored by your anesthesia team. The following are the most frequently asked questions by parents regarding general anesthesia for children:
What is the risk of anesthesia for my child?
All anesthetics are drugs and all drugs have side effects. Our main concerns are the ones that potentially could harm your child. Thirty years ago, the risk of serious anesthesia side effects was 1/20,000; today it is 1/200,000, a much safer experience. In addition, the most important factor leading to an adverse outcome is a patient’s general health. Some important medical conditions are high blood pressure, diabetes, asthma, and sleep apnea. Since most children do not have significant health conditions, their overall risk from anesthesia is extremely low.
Why can’t my child eat or drink before surgery?
This is a safety concern. Food (liquids, solids, breast milk) collects in the stomach. When your child goes to sleep, we don’t want the food to regurgitate into the lungs and cause pneumonia. Since different foods empty from the stomach at different time periods, it is important to follow your surgeon’s and anesthesiologist’s instructions BOTH about fasting times and types of foods to be avoided prior to surgery.
Will my child get an intravenous (I.V.)?
General anesthesia in adult patients begins with starting an intravenous, then a series of medications are administered by vein to “induce” anesthesia. However, the process of starting an intravenous on an awake child usually results in unnecessary pain and anxiety. Therefore, most children are given an oral (by mouth) sedative about 15-20 minutes before the start of the procedure to calm them and to facilitate separation from the parents. Next the child is taken to the operating room where they “go to sleep” breathing a an anesthetic gas mixture through a mask. AFTER your child is completely asleep, an intravenous is started for the administration of fluids and pain medications.
During the actual surgery, most children breath an anesthetic gas to keep them asleep. At the end of the procedure, the gas is turned off and the children eliminate the gas through their lungs while being transferred to the recovery room.
Will my child have pain?
Pain is unwelcome in the recovery room. Most children receive a narcotic during surgery and may receive additional pain medications in the recovery room through the intravenous. All drugs are dosed according to the child’s weight and modified by specific medical conditions. In addition, some children may receive nerve blocks (local anesthetic, like going to the dentist) or caudal anesthesia (like an epidural most moms get while having a baby). A caudal anesthetic is very helpful for most surgeries below the belly button. Your anesthesiologist will discuss these techniques with you prior to the surgery.
When can I see my child?
The reuniting of the parents and child as soon as safely possible is one of the keys to a child’s recovery. Children’s basic needs, including seeing their parents and have something to eat or drink, should be met as soon as possible after surgery. However, you won’t be with your child in the recovery room while he or she is coming out from under the deep anesthetic. As soon as your child is awake enough to start looking or asking for you, we will bring you to the bedside. Seeing their parents is the single most important event to children’s well-being and quick recovery.
What can I expect from my child after surgery?
Most children do not get nauseated after surgery. The exceptions appear to be children having eye or ear surgery which temporarily affects their sense of balance. After surgery, some children may appear very sleepy. This usually is secondary to the side effects of the pain medicines, since most of the anesthetic gas is removed from the body very quickly after surgery.
We hope that this information is helpful to prepare you and your child for elective surgery. If your child is having emergency surgery, as might be needed for appendicitis, for example, the anesthetic techniques are different and will be discussed with you by your anesthesiologist prior to surgery. Your child’s safety is extremely important to us as anesthesia providers. We too are mothers, fathers, brothers, sisters and grandparents and we want nothing but the best anesthetic experience for your child.