MY CHILD NEEDS AN ANAESTHETIC

1. What is involved when your child has an anaesthetic

When your child has an anaesthetic they will not have any perception of the surgical procedure that needs to be done. A general anaesthetic means they will be completely asleep. These days we have powerful anaesthetics that create safe, effective anaesthesia and essentially provide a state of controlled unconsciousness along with pain relief and sometimes muscle relaxation to allow a surgical procedure to be done. Almost all procedures required to be performed on children require some form of anaesthesia. Unlike adults who can have some surgeries done under regional local anaesthetic blocks, a general anaesthetic is required in children. This should be done by a person with experience in dealing with the anaesthetic needs of children.

2. What is involved?

Prior to surgery you will have a chance to discuss with the anaesthetist the exact details of what will be involved with your child. Generally, children can be put to sleep in two ways, either breathing gas from a mask or via an injection which is given through a special line that is placed into a vein in your child’s skin, often in the hand or arm. The placement of this line, if required, is done some minutes before surgery. A local anaesthetic cream will almost always be used and applied somewhere in the arm, corresponding to the presence of a vein. After about 30-40 minutes this will have anaesthetised the skin to enable the insertion of a needle in that area.

Generally when your child goes to the operating theatre parents can go into the operating theatre as the child is put to sleep. This usually depends on the anaesthetist and the nature of the procedure but is often encouraged. As such, from the time your child goes to sleep to the time when they wake in the recovery room, you will usually be able to attend to your child. Parents sometimes request to be present during a child’s operation. This is not a policy that is encouraged and, indeed, would be allowed only under extremely exceptional circumstances.

Sometimes minor illnesses such as a cold or flu may present in the days before your child’s surgery. If surgery is not crucial the anaesthetist will usually delay surgery in these situations as it is safer to postpone surgery if your child is not well.

Prior to surgery your child will have to abstain from food and fluids. The time for this varies and you will be given clear guidelines by the anaesthetist at the hospital at which your child is having surgery. Generally, fluid has to be abstained from four hours before the procedure and food for six hours. The reason for this is to reduce the risk of stomach contents getting in your child’s lung while unconscious. If instructions are not followed clearly your child’s operation may need to be cancelled or delayed. Often your child will still need to take any medication they may be on.

The anaesthetist, surgeon and nurses will do their best to make your child’s visit to hospital as pleasant as possible. However, as primary caregiver for your child, your presence through as much of the process as possible is encouraged. If there is evidence of significant anxiety or you have significant concerns, occasionally play therapists will be used prior to the surgical procedure.

There are two general ways of placing your child to sleep. One is to use a mask where the child breaths a gas that will usually place the child to sleep within 30-60 seconds, the other is to use an intravenous line. Once your child is asleep local anaesthetic is often used as well. This may involve an injection at the site of surgery or, occasionally an injection into the back, known as an epidural which will provide very good post-operative pain relief. Children are often given medications during surgery such as Paracetamol, either rectally or orally soon after surgery.

The majority of children’s surgery can be done as day stay procedures with minimal discomfort to the child. It is important as a parent that you are calm. While it is natural to worry, try not to show this to the child. You might like to talk generally about what to expect in a hospital such as corridors, beds, etc. Reassure your child that everything done in the hospital stay will explained and feel free to ask any questions.