Q: Is anaesthesia safe in children? Edit
Your child’s anaesthetist is a doctor who has specialised in anaesthesia. It takes many years of training to become a specialist anaesthetist. As part of their training they become experts in pain management, resuscitation, care of the critically ill patient as well as paediatrics.
Specialist anaesthetists have extensive knowledge of anaesthesia medications and how they interact with your child’s body. It is because of this extensive knowledge that complications from anaesthesia are rare. When complications do occur your anaesthetist has the skills and knowledge to manage these.
Your anaesthetist will stay with your child for the duration of the operation and monitor your loved one closely and ultimately your child’s well-being during and immediately following surgery is the responsibility of your anaesthetist.
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Q: What are the side effects of anaesthesia? Edit
It is not possible to outline every complication but below is a brief description of common and serious side effects. It is important to know that if your child is essentially well without serious medical problems, the chance of a severe complication from anaesthesia is rare.
Nausea and Vomiting
Nausea and vomiting is not common in young children but becomes more common once children reach puberty. Your child’s anaesthetist will usually give medications to try to prevent vomiting however some risk will remain.
Pain
Your anaesthetist aims to make your child as comfortable as possible following their procedure. Children vary greatly with their pain relief requirements for surgery and pain control techniques make need to be adjusted. If your child wakes with pain in recovery, they will be given pain relief quickly.
Sore Throat
It is a necessity of anaesthesia that we ensure that your child breaths well while asleep and this generally involves placing a breathing tube in his/her throat once they are asleep. This may cause a small amount of throat discomfort and/or hoarseness of their voice which may last for a few days and is rarely persistent.
Skin Bruising
Commonly there may be bruises at the site of an intravenous drip or other injections. Children can often be more difficult than adults and several attempts might be required. Generally children are already asleep when these attempts are made and therefore should not cause any distress to your child.
Allergic Reaction
Although uncommon, every time your child is exposed to new medication there is a small chance that he/she may have a reaction. This risk is the same with anaesthetic medications. These reactions can vary from a rash to more serious breathing and blood pressure problems. If your child has one of these reactions his/her anaesthetist is trained to manage this situation immediately.
Breathing problems
Anaesthesia can cause breathing problems. These problems are more common in children with pre-existing asthma or other medical problems such as sleep apnoea. The risk may be higher if your child has had a recent or currently has a cough or cold. Another serious complication called aspiration can occur if stomach contents get into the lungs and damage them. This is more likely with emergency surgery or when inadequate fasting has occurred prior to your child’s operation.
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Q: How long does my child have to fast? Edit
Fasting is essential for safe anaesthesia. Your child needs to fast from all food (including lollies and chewing gum) and milk drinks (including formula) for 6 hours prior to their operation. This ensures that their stomach is empty and reduces the risk of aspiration (see complications of anaesthesia). Clear fluids (e.g. water, apple juice) may be given to your child up to 2 hours before their operation.
If your child takes regular medications this should be discussed with his/her anaesthetist prior to the day of surgery.
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Q: How can I as a parent help? Edit
You also have a key role to play in your child's care.
Begin preparing your child for the operation as soon as a decision is made to proceed to surgery. Children tolerate surgery better when they are well prepared.
As with all of us, children have anxieties. Unlike adults, children often lack the ability comprehend why certain things are happening and this will manifest as emotional distress. Give your child a simple explanation of what is going to happen and start doing this a few days before their surgery. Honesty is a key word. Your child should be told that he or she will be in unfamiliar surrounds but will meet many friendly doctors and nurses. Tell them that they will have an operation and that there may be some discomfort afterwards. Let them know that you may not be with them every minute but will always be waiting nearby.
Your composure as a parent is essential. Nothing calms a child more than a confident and calm parent. Being present when your child is anaesthetised is often helpful and it is common for one parent to be present as your child goes off to sleep. However this can be upsetting for some parents and it is not an expectation that you are present while your child goes off to sleep. Ultimately it is the decision of your child’s anaesthetist as to whether you will be present or not. The anaesthetist will discuss the options with you and your child prior to your anaesthetic.
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Q: How will my child be given anaesthesia? Edit
Prior to surgery you will meet with your child’s anaesthetist. This may be on the day of surgery or several days prior in the Wide Bay Anaesthesia consulting rooms. After examining your child and asking questions about your child's health and anaesthetic history, he or she will discuss the options for anaesthesia.
Anaesthesia can be achieved in several ways. In adults anaesthesia is most commonly achieved by an injection into your vein which is very rapid. It is less common in children due to the distress associated with needles. Generally if this option is decided upon by your anaesthetist it is because he or she thinks it is safer for your child. Generally a special numbing cream is applied to your child's hand to reduce the distress associated with doing the needle before going to sleep.
Another method is to let your child breathe anaesthesia gas through a mask. The gas is a sweet smelling gas which is usually well tolerated. This is a slower method of achieving anaesthesia but does not require a needle before going to sleep and is often preferred by children and parents.
The choice of which method to begin anaesthesia will be made by the anaesthetist based on many factors, and after consultation with you and your child.
Sometimes a medication will be given prior to the operation. This could be paracetamol to help with pain relief after the operation or occasionally it will be a relaxing medication if your child is anxious or distressed.
After the operation your child will go to the recovery room where they will be monitored as the anaesthetic wears off. Often this will be where you will first see your child after their operation. Children will generally be drowsy after their operation. Occasionally they can be distressed and you may be called upon to help calm them down.
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Q: How will my child's pain be controlled after surgery? Edit
Your child’s anaesthetist has a very important role to play with the management of pain after surgery.
Your child will be given pain relief medications while they are anaesthetised to make the child as comfortable as possible when they wake up. If your child is uncomfortable immediately following surgery it can be addressed quickly with further administration of pain medications in the recovery room.
After the operation pain relief is usually offered as tablets or syrups. Commonly used medicines include paracetamol, anti-inflammatories (eg. ibuprofen) and codeine. For major surgery, stronger medicines given through the drip may need to be given. Your anaesthetist will discuss with you pain relief options.
In some instances more advanced techniques of pain relief may be offered such as nerve blocks and caudal blocks. If this is the case your child’s anaesthetist will discuss this in more detail with you prior to the surgery.
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