What is Anesthesia
The Division of Pediatric Anesthesia at Arkansas Children’s Hospital has answers to questions frequently asked by parents.
- What is Anesthesia?
- Who will be providing the anesthesia?
- What information should I provide the medical staff?
- What are the common side effects of anesthesia?
- How do I prepare my child?
- Why can’t my child eat before his or her surgery?
- What will happen the day of surgery?
- What should I do if my child becomes sick before surgery?
- What can I do to help make my child’s surgery go smoothly and safely?
What is Anesthesia?
Anesthesia is provided to children and adults so that they will not feel any discomfort during an operation or diagnostic procedure. The most common type of anesthesia is “general anesthesia,” in which the patient is unconscious and cannot feel pain or any other sensation. Other techniques that may be used include “regional anesthesia” (injecting medication near an area of nerves to block the transmission of signals to the brain), and “sedation,” a condition in which the patient is awake yet quite sleepy.
Who will be providing the anesthesia?
The anesthesia will be provided by our specially trained team of physicians called anesthesiologists. The anesthesiologists may be assisted by other members of our anesthesia team, including pediatric anesthesiology fellows (anesthesiologists pursuing further training in pediatric anesthesia), anesthesia residents (physicians training to become anesthesiologists), certified registered nurse anesthetists (registered nurses who have completed additional formal education in the administration of anesthesia) and anesthesia technicians. Members of the anesthesia team are present with your child throughout the surgery or procedure. They not only administer the anesthesia medications, but also continuously monitor the patient, and perform procedures such as airway management, IV and arterial catheter placement, and placement of regional nerve blocks and catheters.
All members of our faculty are board certified by the American Board of Anesthesiology or are currently enrolled in the ABA examination process. All members of our faculty have also completed a fellowship in pediatric anesthesiology which we believe makes them uniquely prepared to meet the physical, developmental, psychological, and emotional needs of infants, children, and adolescents requiring anesthesia or sedation.
What information should I provide the medical staff?
You should provide the medical staff with the following information about your child:
- History of medical problem leading to surgery
- Other medical problems, especially those concerning the heart or lungs
- Allergies to any medications or foods
- A list of current medications
- A list of other medications your child has recently taken
- History of previous anesthetics, especially any problems
- History of any problems with anesthesia in the family
- Any current illnesses, such as colds or the flu
What are the common side effects of anesthesia?
- Fatigue, dizziness
- Shivering
- Pale, puffy, swollen appearance
- Nausea and vomiting
- Sore throat
- Congestion and cough
- Skin rashes, swelling, and itching
- Bruising and discomfort at needle sites
- A restless or irritable wake up in which the child may cry, thrash, arch their back, reach out and seem inconsolable can occur. This is known as “emergence delirium” and can last between 10 minutes to an hour.
How do I prepare my child?
- Be honest with your child about where he or she is going. Do not lie to your child.
- Reassure your child that he or she will be asleep during surgery and will wake up after surgery.
- Reassure your child that a family member will be with him when he wakes up from surgery.
- Younger children (about 8 years and under) should have things explained in terms that she will understand. For example, you might tell your four-year old that she will have an operation to “fix her tummy” or to “make her tummy better” and that she will be asleep when she has that operation. It may also help to have your younger child pick one item, such as a favorite toy, blanket, or stuffed animal to bring with her to the hospital for security.
- Older children and teenagers (about 9 years and older) should be given as much detail and information as you think they can handle. Try to encourage your child to ask questions. Help your child think of ways to make waiting for surgery easier, such as bringing a book to read or music to listen to through headphones
Why can't my child eat before his or her surgery?
This will vary by the age of your child, but in general, children cannot eat and drink after a certain time prior to their surgery. If you do not follow these fasting instructions and your child receives anesthesia, serious complications can occur, including death. It is extremely important that you follow the fasting schedule that has been discussed with you.
Your child’s safety is our primary concern!
What will happen the day of surgery?
Pre-anesthetic evaluation:
After registering, you will have a meeting with anesthesia staff to discuss your child’s current health and medical history before anesthesia can be administered. You may also ask questions and/or let staff know about any worries or concerns that you or your child may have.
Waiting Room:
After the pre-anesthetic evaluation, you and your child will go to an area to wait for surgery. In the waiting room, your child may be given a medicine (called “premedication” or “premed”) to help him or her relax before surgery. The premedication is often given in a liquid for your child to drink, but it can also be given in other ways, such as an injection. If your child will be given a premedication and how it will be given will depend on your child’s age (older children and teenagers may be less likely to need premedication), medical condition and whether there is time for the medicine to work.
Going to the Operating Room:
- Your child may be taken to the operating room on a stretcher or be carried.
- You may give your child a kiss and tell him that you will see him or her in a little while.
- Although care is taken to avoid making your child upset, separation may still cause some nervousness or anxiety.
- The medical staff will take good care of your child!
Anesthesia Induction:
There are three major ways that your child may have anesthesia started (called induction):
- By mask, where anesthetic gas is given that your child will breathe (usually for smaller and younger children),
- By an intravenous (“IV”) line, with anesthetic medicines (usually for older children), or
- By an intramuscular (“IM”) injection (usually used when a child will not accept the mask or IV)
Your child’s anesthesiologist will decide the best method of anesthesia induction for your child.
Recovery Room:
- After surgery your child will be taken to the PACU (Post Anesthetic Care Unit or the recovery room) to awaken. One parent or caregiver will be called to the PACU to be with your child when he or she awakens. It is often best to have just one person remain with your child throughout the entire time in the recovery room.
- Your child may be groggy or sleepy from the anesthesia. Sometimes children do not behave like their typical selves when they recover from anesthesia. For example, your child might be fussy, cranky, crying, and/or difficult to comfort.
- If your child will be admitted to the hospital after recovery, he or she will go directly to a hospital room from the PACU.
- If your child is going to be discharged following surgery, he or she will be taken to the outpatient recovery area for about an hour before discharge. Both parents can usually visit in this other recovery area.
- It is best for your child not to have a lot of family and friends at the hospital to visit your child before he or she is discharged. Your child needs to rest while recovering from anesthesia and surgery.
- Your child will be discharged when he or she has recovered from anesthesia.
After Discharge:
- You will receive written instructions regarding the care of your child at home.
- On your child’s postoperative care instructions, there will be phone numbers listed for you to call if you have problems, questions or concerns about your child’s health.
What should I do if my child becomes sick before surgery?
If you believe your child may be catching a cold or flu or becoming ill in some other way before his surgery, please contact the ambulatory surgery center and your child’s primary care physician.
What can I do to help make my child’s surgery go smoothly and safely?
- Arrive at your child’s scheduled appointment on time to avoid delays and delaying other surgeries.
- Follow all instructions carefully, especially NPO instructions.
- Remain flexible since emergencies or other uncontrollable factors may result in unexpected delays.
- Take care of yourself! Do not fast with your child – get up earlier than your child and eat a good breakfast so that you are physically ready to provide emotional support for your child.
