If your child needs surgery or a diagnostic test which will require anesthesia, preparing for anesthesia usually starts long before the anesthesiologist is involved. Your doctor's office will make all the necessary arrangements for you and will begin an assessment.
Watch a video from Cleveland Clinic Children's Hospital on what to expect when a child comes in for surgery.
In some cases, you or your child (if old enough) may be asked to take a preoperative survey called ChildQuest. In other cases, your surgical case manager will go over the same questions verbally. It is important that you answer the questions as truthfully as possible. This survey is designed to help us identify potential risks to your child during and after anesthesia. Certain prescription and non-prescription medicines may significantly affect anesthesia and certain symptoms or conditions may also increase risks, or cause delays, if not known in advance.
In most cases, your child will then be scheduled for surgery. In some cases, a pre-anesthesia review and assessment may be scheduled before the surgery to date to assess special situations.
Pre-Surgery Guidelines
Your doctor's office will also give you a set of instructions on how to prepare for surgery. Chief among these recommendations will be guidelines for your child's medications along with guidelines for eating and drinking in the hours before surgery. It is important to follow these instructions carefully and let the staff know if there was any divergence from the instructions before surgery starts.
The following are the general food guidelines. However, please refer to the specific instructions you were given by your doctor's office as they may differ significantly depending on your child's individual needs. If you have any questions, please call your doctor's office. In an emergency after hours, please contact the Cleveland Clinic Nurse-On-Call at 216.444.1234 or 800.801.2273.
In general, the guidelines specify that a patient should not eat solid food for eight hours before surgery and nothing more than a light meal or snack (crackers, soft food, etc.) for six hours before surgery. If the child is being breast fed, he or she should not nurse beyond four hours before surgery. Because children get dehydrated more quickly than adults, the general guidelines allow for clear liquids such as water, apple juice or Gatorade up to two hours before surgery, a rule that differs from the adult guidelines.
It is very important that you follow the guidelines you are given before surgery. failure to do so may result in a delay of surgery, or if not known by our staff, it could even add significant risk to the surgery or result in discomfort afterward. We understand that, occasionally, children will disobey and eat or drink during the restricted times. However, it is of utmost importance to notify your anesthesiologist —even if it will delay surgery— failure to mention such behavior could put your child at unnecessary risk. It is also very important to follow whatever guidelines you have been given regarding any medications (prescription or nonprescription) your child may be taking.
Day of the Procedure
A Child Life specialist will help the child
and family know what to expect
When you arrive for your scheduled surgery or diagnostic test, a Child Life Expert and an Anesthesiologist or Nurse Anesthetist will meet with both the child and his or her parents. The procedure will be explained to the parents and to the child, depending on the age of the patient. The child may be introduced to the anesthesia mask and other often intimidating equipment in order to provide the patient with a level of comfort regarding the equipment come time for the surgery. The practitioner will also give the child an oral sedative to help keep them calm allowing the process of anesthesia to begin even before the child enters the operating area.
At this time, the staff will also discuss any planned recovery issues and post-surgical pain management with the family and child.
One parent will be allowed to accompany the child into the operating room while the child goes to sleep. The rest of the family may wait in the family lounges until the child enters the recovery room and begins to wake up. A parent will then be called back to the recovery room, ensuring the child will wake up with a familiar, smiling, face at his or her side.
Recovery, Post-Surgical Pain and Going Home
In most cases, the parents will know before surgery whether the child will be spending the night or returning home that evening. This is dependent on how ill the child is, what surgery was performed, the duration of anesthesia, and whether there are any signs of the child being in discomfort or recovering slowly from the surgery or anesthesia. Even if the child is unexpectedly in need of an overnight stay for more observation, it shouldn't be seen as something to worry about. Our staff takes the child's comfort and safety very seriously, and may sometimes request the child stay for additional observation, just to be sure everything is as it should be.
If the child recovered well from the surgery and feels well enough to be returned home, the nurses and the anesthesiologist will give you full instructions on how to care for your child post-anesthesia along with a list of some things to watch out for. In general, it is best to contact your doctor or the clinic immediately if any of the following occur:
- nausea
- unexpected pain
- trouble breathing
- red rash
