Your child and anesthesia
What you can expect if your child needs to be ‘asleep’ for a medical procedure
An upcoming procedure that involves anesthesia can cause anxiety for children and their parents and families.
However, it is important to remember that anesthesia is administered by highly trained physicians and nurses following rigorous safety standards. Therefore, anesthesia is actually among the safest of medical specialties and, of course, it is what allows children to “sleep” through procedures without pain.
What can you expect if your child needs anesthesia? Usually, the child should not eat eight hours before the procedure to avoid potentially dangerous problems related to having a full stomach, but clear fluids such as apple juice or water can be given until two hours before.
After you check in for the procedure, the anesthesiologist will perform a history and physical exam. This is to make sure that your child is healthy, or appropriately treated in case of a chronic health problem, because some conditions, especially a cold or a history of wheezing, can increase anesthesia risk.
Of course, children with asthma and other health conditions can still safely undergo anesthesia; your anesthesiologist will discuss with you if and how this affects the procedure. He or she will also inform you about possible side effects.
Depending on the procedure, a scratchy throat, some discomfort or pain around the surgical site, queasiness, or a brief episode of confusion and agitation (“delirium”) may occur. Usually, these side effects are mild and readily treated. Serious or dangerous side effects, such as an anaphylactic reaction, are incredibly rare. However, your anesthesia team is trained to immediately recognize and treat these conditions.
When it is time to get started the child will be brought to the operating room or procedure area. Often a parent can be present until the child is asleep. The anesthesia team and sometimes a Child Life Specialist – a person with special training to help children and families cope with the hospital environment – will engage the child in age-appropriate conversations and distractions.
This ranges from reading stories to arts and crafts to playing games on the iPad (who said you can’t have fun at the hospital?).
Some particularly anxious kids may get a sedative before entering the operating room. For most children younger than 10, anesthesia will initially be given in gas form through a plastic face mask, and an intravenous line (IV) is placed after they are asleep. Occasionally, a child may need an IV before they are under anesthesia, especially for emergency procedures. If this is the case, a numbing medication known as a local anesthetic can be applied before the needle stick.
After the procedure, your child will be brought to the recovery area. Parents are typically allowed to be around when the child starts to open their eyes. Some children may need a while to “sleep it off,” but many are ready for a Popsicle soon after the procedure.
While far from your usual routine, a procedure under anesthesia does not need to be a scary experience for you and your child. Knowing what to expect helps families and children to prepare. Many hospitals offer informational materials including photos and video clips featuring the local practice. And you can always request to talk to an anesthesiologist ahead of time.
Hedwig Schroeck is assistant professor of anesthesiology at The Geisel School of Medicine at Dartmouth. For more information on pediatric anesthesia services at the Children’s Hospital at Dartmouth-Hitchcock, go to www.chadkids.org.