Children and Anesthesia

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Surgery and other procedures that require anesthesia aren’t fun for anybody, let alone a baby or a child. It can be a frightening experience, even before the actual event. Our child recently underwent a minor medical procedure under general anesthesia. Although we were very thorough as far as research and consultations with medical professionals, it has definitely been a stressful week.

baby and anesthesia

Photo courtesy of Joey Powling Jr.

 

Though general anesthesia is considered to be very safe, we were concerned about a few recently published medical studies that indicate possible effects of anesthesia–especially in children under age 3–that don’t show themselves until later on, such as language and memory problems.

An emergency medical condition can occur suddenly, leaving parents unprepared when facing their child’s surgery or an urgent treatment under full anesthesia. We thought it would be helpful to outline the facts that everyone–especially parents–should know, and provide a few suggestions on how to minimize stress.

There are 3 types of anesthesia that can be administered based on the actual procedure and the health condition of the patient.

  1. General anesthesia means that patient will be given medication (anesthetics) that will put him in a full state of unconsciousness; he will not be aware of anything happening to him or feel a thing. General anesthesia is usually used in major surgery, but also in some treatments that need a child to be completely still, such as eye surgery, removal of tonsils and circumcision.
  2. Regional anesthesia is applied only to a larger area of the body such as a leg or arm. The patient is fully awake and might be aware of the procedure but doesn’t feel a thing as the area is completely numbed. Regional anesthesia is used for minor surgeries or treatments.
  3. Local anesthesia is applied to a smaller, targeted area of the body. The patient is fully awake and might be aware of the procedure but doesn’t feel a thing as the area is completely numbed. Local anesthesia is used in minor surgeries and treatments like dental or skin work.

If a medical procedure or surgery is planned, you should have at least a few days to get prepared, though in case of an emergency, your child might have to go under anesthesia immediately.

How do I prepare for anesthesia?

For a planned procedure, your general practicioner (GP) or a specialist will give you a list of necessary tests and instructions, which will vary according to health condition, the child’s age and type of treatment, but will include some or all of the following:

  • blood test
  • urine test
  • liver test
  • EKG heart test
  • Pulmonary test
  • X-rays
  • Overall pre-surgery exam by GP with recommendations

These tests are usually required a few days before the procedure to make sure they are the most current.

You will also be provided with a list of instructions before check-in at the hospital, which usually means a day before the surgery. Again these instructions vary, but for a general anesthesia, you will probably need to observe the following instruction:

  • Lunch the day before surgery should exclude heavy foods.
  • Afternoon snacks should exclude chocolate, fruit and vegetables.
  • Dinner should be very light: yogurt, porridge or other foods that are easy to digest.
  • No more food after midnight.
  • The last drink consisting of clear liquids such as water, tea or apple juice should usually not be consumed more than four hours before the planned surgery or two hours before admission to the hospital; however you might be instructed not to serve any liquids after midnight.

It’s crucial that you follow these instructions exactly. When general anesthesia is administered, it also relaxes muscles in your digestive tract and airways. These muscles normally keep food and acid in your stomach and out of your lungs. It’s imperative that the stomach, digestive tract, and bladder are empty before anesthesia; otherwise, possible vomiting during surgery could cause complications.

Upon check-in at the hospital, a supervising doctor will go over all results and interview the parent or guardian about the following:

  • The child’s current and past health.
  • The family’s health history including parents’ use of alcohol, tobacco or drugs.
  • Medications, supplements, or herbal remedies your child is taking.
  • Previous surgeries or procedures that used any kind of anesthetic.
  • Allergies (mainly to medication, food, latex or other).

Again, it’s very important to provide accurate and honest information to make sure your child will be safe during anesthesia. Based on these facts an anesthesiologist will review and decide on the right type of anesthesia.

The day of the surgery, try to stay calm and relaxed. Children are very observant; they’ll pick up on any nervousness or stress around them. Make a plan for entertaining your child during the waiting period and keep her busy so she doesn’t keep asking for drinks and food. If you’re allowed to give your child a drink when she wakes up, plan to get up a bit earlier so you can eat some food yourself; it’s hard to keep a frightened child calm when you’re hungry.

We ended up spending almost six hours from the time we got up in the morning until our child was served a calming pre-anesthesia medicine, and passing that time wasn’t an easy task. Bring his favorite toys and plan for some fun activities you might be able to do in a hospital playroom.

When your child is in the operating room, take a walk, eat and try to relax rather than waiting in the hospital. Once he is out of anesthesia, chances are he will be very grumpy and irritated and might require your attention and comfort for hours.

He will be connected to an IV and hooked up to monitors, and unable to eat or drink for several hours at the very least. You won’t be able to eat or drink in front of him, so be prepared. If your child has a favorite treat he gets only on special occasions or a place he loves to visit, talk about taking him there soon after the hospital visit to get his mind off any discomfort. Hopefully this will make the process much easier for everybody–including the hospital staff. And before you know it, it will be over and you’ll all be headed home.

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