The anaesthetist will be with your child and caring for them the whole time they are unconscious. They are assisted by highly specialised machines which help to watch your child’s breathing and circulation.
Communicate with your child
As a parent, you obviously have an intimate understanding of your child’s personality. However older children often respond well to information about surgery and anaesthesia. Providing a positive simple explanation of the planned procedures ahead of time will often help the child deal with any anxieties they may have. Withholding this information until arrival at the hospital may not be helpful.
Choosing how your child’s anaesthetic is given
There are different ways to start an anaesthetic. For instance, we may use gas through a face mask or place a plastic tube or needle into a vein. There are also different ways to provide your child’s pain relief after an operation.
It is usually possible for you and your child to choose how the anaesthetic and other medicines are given but sometimes there are important medical reasons why things have to be done in a certain way.
Your wishes and those of your child are very important to us. We understand that you and your child are best placed to tell us what you need. We will not do anything without discussing it with you first.
It is very important that you understand and agree with how we are planning to give the anaesthetic as we want to provide the best possible care for your child.
Please ask your anaesthetist if there is anything you would like to know or don’t understand.
What your anaesthetist needs to know:
- Detailed information about your child’s medical and surgical history
- What medicines your child is currently taking
- Whether your child or members of your family have any allergies or unusual reactions to drugs or anaesthetics
- If your child has had an anaesthetic before and has gone to sleep and woken up well
The anaesthetist will examine your child and then talk to both you and your child about the anaesthetic and the choices available.
Side effects and complications
Anaesthesia is very safe, and serious complications are very rare. We do our best to ensure this but there will always be a risk of unplanned things occurring during and after anaesthesia and surgery. Some children are more at risk than others because of their medical problems or the surgery they are having.
Your anaesthetist will discuss these possible risks for your child with you before the operation. It is important to remember that your anaesthetist has had special training to prevent complications and treat them if they happen. We are not listing the following complications to alarm you. They are here so that you can look at them and ask your anaesthetist about any one of them that might particularly worry you.
General anaesthesia side effects include:
- When a plastic needle (cannula) is put into a vein for the injection of drugs and fluids, skin bruising at this site is fairly common but usually gets better quickly
- Most children have a breathing tube placed into their windpipe or mouth to help them breath. This may cause a sore throat and possibly a hoarse voice
- Nausea and vomiting may be caused by many things including anxiety, the surgery and the pain-relieving and anaesthetic drugs (such as morphine) that we use
- Both you and your child may feel some emotional distress at the start of the anaesthetic or while they are waking up afterwards
- Your child may have some pain after surgery. They will receive pain relief to help with this
- Damage to a tooth or teeth
- An unexpected severe allergic reaction to a drug
- Vomit entering the lungs causing serious problems – this is why it is important that your child’s stomach is empty at the time the anaesthetic is given
- Awareness – being awake during the operation
- Serious and even permanent damage to the heart, lungs or brain which could possibly cause permanent disability or death
Fasting (no eating or drinking before surgery)
We appreciate how hard it can be for a child to fast, but it is very important for you and your child to follow the fasting instructions you are given. If there is food or liquid in your child’s stomach during the anaesthetic, it could come back up and then enter their lungs as they go off to sleep and cause serious damage.
For children over six months of age having an elective procedure, breast milk or formula and limited solid food may be given up to six hours and clear fluids (no more than 3ml/kg/hr) up to one hour prior to anaesthesia.
For infants under six months of age having an elective procedure, formula may be given up to four hours, breast milk up to three hours and clear fluids (no more than 3ml/kg/hr) up to one hour prior to anaesthesia.
Staying with your child
It is common for toddlers and older children to be accompanied to the operating theatre by a parent, who stays until anaesthesia is induced. However, this is not always appropriate, and your anaesthetist will discuss a plan to suit the circumstances.
Your child will spend some time (at least 20 minutes) in the recovery room waking up after their anaesthetic.
One parent may be invited into recovery to be with your child as they wake. As the effects of the anaesthetic are wearing off, your child may be disorientated, feel dizzy or have blurry vision. This is normal and every child may behave slightly differently.