If your child is coming in for surgery or a diagnostic test which will require anesthesia, the process of preparing for anesthesia usually starts long before the anesthesiologist gets involved. Your doctor's office will make all the necessary arrangements for you and will begin the assessment.
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from Cleveland Clinic Children's Hospital on what to expect when a child comes in for surgery.
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Read the transcript here
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 you answer the questions as truthfully as you can. 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 and for eating and drinking in the hours immediately 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 which differs from the adult guidelines.
It is very important that you follow the guidelines you are given before surgery. Not doing so might delay surgery, or if not known by our staff, could even add to the risk of surgery or discomfort afterwards. Sometimes it happens that children get around you and eat or drink during the restricted times. It is important to tell your anesthesiologist about this—even if it will delay surgery—because not mentioning such issues could put your child at more risk than is necessary. 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 the Anesthesiologist or Nurse Anesthetist will meet with both the child and the parents. The procedure will be explained to the parents and to the child if they are old enough to understand. The child may be introduced to the anesthesia mask and other equipment to touch and play with so this equipment will be less scary when used for real. The practitioner will also give the child an oral sedative to help keep them calm and begin the process of anesthesia even before the child goes into 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 and the family can wait in the family lounges until the child is in the recovery room and starting to show signs of waking up. A parent will then be called back in to the recovery room so the child can wake up to a familiar face.
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 going home that evening. This is dependent on how sick the child is, what the surgery is, how long they must spend under anesthesia and whether there are any signs the child is in discomfort or reacting badly to the surgery or anesthesia. Even if the child is unexpectedly held overnight for more observation, this shouldn't necessarily be seen as something to worry greatly about. Our staff takes the child's comfort and safety very seriously and may sometimes request the child stay for observation just to be sure everything is all right.
If you take the child home, the nurses and the anesthesiologist will give you full instructions on how to care for your child post anesthesia and will give you a list of some things to watch out for. In general, contact your doctor or the clinic immediately if you notice any of the following:
- nausea
- unexpected pain
- trouble breathing
- red rash
Next: Pediatric Anesthesiology Educational Opportunities...
