When Your Child Needs Surgery: Anesthesia
Your child is having surgery. During surgery, your child will receive anesthesia. This medicine causes your child to relax and fall asleep, and not feel pain during surgery. See below for more information about different types of anesthesia. Anesthesia is given by a trained doctor called an anesthesiologist. A trained nurse called a nurse anesthetist may also help. They are part of your child’s operating team.
Types of anesthesia
Your child may receive any of the following types of anesthesia during surgery.
General anesthesia is the most common type of anesthesia used. It may be given in gas form that is breathed in through a mask. Or, it may be given in liquid form in a vein (through an intravenous (IV) line). Sometimes both methods are used. General anesthesia causes your child to fall asleep and not feel pain during surgery.
Regional anesthesia may be used for certain surgical procedures. Part of the body is numbed by injecting anesthesia near the spinal cord or nerves in the neck, arms, or legs. Your child may remain awake or sleep lightly.
Monitored anesthesia care (also called monitored sedation) is often used for surgery that is short, and that does not go deep into the body. Sedatives may be given through a vein (an IV line). Sedatives are medicines that help your child relax. A local anesthetic (numbing medicine) may also be used. Your child may remain awake or sleep lightly. But he or she will likely not remember anything about the surgery.
Follow all food, drink, and medicine instructions given by your child’s healthcare provider. This usually means that your child can have nothing to eat or drink for a set number of hours before surgery.
On the day of surgery, you and your child will meet with an anesthesiologist. He or she will go over with you the type of anesthesia your child will receive during surgery. You may need to sign a consent form to allow your child to receive anesthesia.
Let the anesthesiologist know
For your child’s safety, let the anesthesiologist know if your child:
Had anything to eat or drink before surgery.
Has any allergies.
Is taking medicines.
Has had any recent illnesses.
Anesthesia may be started in a room called an induction room. Or, it may be started in the operating room.
You may be allowed to stay with your child until he or she is asleep. Check with your child’s anesthesiologist.
During surgery, the anesthesiologist or nurse anesthetist controls the amount of anesthesia your child receives. Special equipment is used to check your child’s heart rate, blood pressure, and blood oxygen levels.
Anesthesia is stopped once surgery is complete. Your child will then wake up.
Your child is taken to a postanesthesia care unit (PACU) or a recovery room.
You may be allowed to stay in the PACU or recovery room with your child. Every child reacts differently to anesthesia. Your child may wake up disoriented, upset, or even crying. These reactions are normal and usually pass quickly.
When ready, your child will be given clear liquids after surgery. He or she will gradually be given solid foods and return to a normal diet.
The surgeon will tell you if your child needs to stay longer in the hospital after surgery. If an overnight stay is needed, you’ll usually be told ahead of time.
Follow all discharge and home care instructions once your child leaves the hospital.
When you should call your healthcare provider
Call your healthcare provider right away if any of these occur:
Nausea or vomiting
A sore throat that doesn’t go away
Worsening post-surgery pain
Fever (see Fever and children, below)
Fever and children
Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.
For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.
Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.
Infant under 3 months old:
Ask your child’s healthcare provider how you should take the temperature.
Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider
Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider
Child age 3 to 36 months:
Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider
Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider
Child of any age:
Repeated temperature of 104°F (40°C) or higher, or as directed by the provider
Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.
October 08, 2017
Strom, Current Opinion Anesthesiology (2012); 25; pp. 321-5
Adler, Liora, C., MD,Dozier, Tennille, RN, BSN, RDMS,Turley, Ray, BSN, MSN