Pediatric Anesthesia

The information here is to help parents and/or guardians prepare and better anticipate their child’s anesthetic experience.  Hopefully it will help you feel more comfortable and help you support your child through their surgery or procedure.  Feel free to ask staff or your anesthesiologist about any questions you have about your child’s anesthesia.

Pre-op

On the day of surgery you will be able to meet and talk to your anesthesiologist.  You can help by complying with the fasting guidelines (below) and being aware of your child’s medical problems and current medications.  You can help prepare your child by talking to your child and making a plan for what to do when they feel nervous.  Ideas that may be helpful include bringing a book they like to read, telling them a story they like, or talking about something fun they like to do.  Staying calm will likely benefit your child as well because your child will take emotional cues from you.  If you can comfort and encourage your child and respect their feelings they will likely have a better experience.  In some cases oral mediation may be given to help with anxiety.

Anesthesia

Our anesthesiologists will frequently allow one parent to be present in the operating room as his or her child receives anesthesia.  If you would like to be present please let your anesthesiologist know.  There are some situations in which we may need to decline your request and we will discuss it with you at that time.  Once your child is asleep you will need to leave the operating room so that the operating room team can focus on caring for your child.  Parents are not permitted in the operating room during surgery.

Most children initially receive anesthesia by breathing anesthesia gases and oxygen through a mask.  This takes about 1-2 minutes to cause your child to go to sleep.  After they are asleep they may require an IV so that they can receive fluid and additional medications. Older children (generally about 10 years old and above) will receive an IV before going to the OR and will receive anesthesia through their IV to put them to sleep.

As your child falls asleep you may notice some changes that are a normal part of anesthesia.  This may include heavy, deep, or loud breathing.  Sometime children will move after initially relaxing, and it can be vigorous movement of both arms and legs, but your child will be unaware this is happening and it will pass. Only partial closure of your child’s eyes or rapid eye movement and rapid blinking as your child goes to sleep can also be normal.  We will notify you once he/she is completely asleep and when you need to leave so that we can care for your child, at which point the nurse will direct you to the waiting area.

Recovery Room/PACU

After your child’s surgery is complete they will be taken to the recovery room.  Every child will wake up differently from anesthesia.  Some children will wake quickly and some will take longer, this is affected by the type and length of surgery and the medications they received during surgery.  Frequently children wake up disoriented and restless, this can be common and children do not typically remember this transition period to being alert and fully awake. Sometimes pain or sedative medications will be given to help calm your child.  The type of surgery and the anesthesia required will determine the amount of time your child will need to spend in the recovery room.  It can be 15 minutes to over an hour.

Fasting Guidelines

Safety is our highest priority as we care for your child and in order to reduce the risk of severe complications, we request that all patients follow these specific guidelines for fasting prior to surgery.  For safety reasons your surgery may need to be delayed or rescheduled if you have not kept to these guidelines.

Newborns to 6 Months of Age – Do not eat solids or drink milk 4 hours prior to surgery. You may have clear liquids* up to 2 hours before surgery.

Children 6 Months to 36 Months – Do not eat solids or drink milk 6 hours prior to surgery. You may have clear liquids* up to 3 hours before surgery.

Children 36 Months to 4 Years – Do not eat solids or drink milk 8 hours prior to surgery. You may have clear liquids* up to 3 hours before surgery.

Children 4 to 14 Years of Age – Do not eat solids or drink milk starting at midnight of the day before surgery. You may have clear liquids* up to 4 hours before surgery.

Children 14 Years and Older – Do not eat solids or drink milk starting at midnight of the day before surgery. You may have clear liquids* up to 6 hours before surgery.

 

*Clear liquids are: water, apple or white grape juice, coffee or tea without cream or milk, and Gatorade. Please do not eat/drink Jello, broth, gum, mints, hard candy, carbonated beverages or sodas.