Childrens Services

Anaesthesia for children

What is anaesthesia?

The word ‘anaesthesia’ means ‘loss of sensation’.

  • A general anaesthetic ensures that your child is unconscious and free of pain during a test (investigation) or operation.
  • General anaesthesia is a state of controlled unconsciousness and freedom from pain. 
  • Anaesthetics are the drugs (gases and injections) that are used to induce and maintain anaesthesia.
  • Anaesthetists are specialist doctors who are responsible for the wellbeing of your child throughout surgery.
A general anaesthetic ensures that your child is unconscious and free of pain during a test (investigation) or operation.

Anaesthetists are also closely involved with your child’s pain relief after surgery.

Choice

It is often possible for you and your child to choose how the anaesthetic and other medicines are given. Sometimes there are medical reasons why things have to be done in a certain way – these will be explained to you.

Nothing will happen unless you understand and agree with what has been planned. Your wishes and those of your child are very important. We want to work with you to provide the best possible care for your child and family.


PreparationShow [+]Hide [-]

There are many things that you can do to prepare your child for coming into hospital. All children (except infants too young to understand) should be told:

  • that they are going into hospital
  • that they will be having an operation or investigation
  • some basic information about what will happen to them when they are in hospital.

Everything should be explained to your child in a way that he/she can understand. The Great North Children’s Hospital has hospital play specialists who can explain and encourage discussion through play.

Timing

Children between two and three years of age should be told two to three days before and again on the day of admission.

Children between four and seven years of age should be told four to seven days before the day of admission.

Older children will usually be involved in making decisions about the operation or investigation and discussion can take place a few weeks before the day of admission.

Some ideas of what to say

  • Explain that the operation or investigation will help your child to get better.
  • Use simple words your child understands.
  • Do encourage your child to talk about the operation and ask questions. Books, games and stories can help.
  • Tell your child about timing – when the operation or investigation will take place and how long their stay in hospital will be.
Explain that the operation or investigation will help your child to get better.

If your child will be staying in hospital overnight, we provide a folding bed next to your child’s bed allowing one parent to stay overnight.

Your child can help pack his or her own bag and decide which nightclothes and toys to bring. Please let us know in advance any special requirements your child has and we will do whatever we can to help.

Illness on the operation day

Please phone the contact number on the admission letter if your child develops a severe cough or cold, or has contact with chicken pox shortly before the day of the operation or investigation.

Visiting the ward

If your child needs to be prepared for the experience by visiting the ward and operating theatres before the day of admission, this can be arranged. Please contact the ward’s play specialist to make a special appointment.

On the day of admissionShow [+]Hide [-]

A pre-operative visit

An anaesthetist should visit you on the ward before the procedure to discuss your child’s anaesthetic.

The anaesthetist needs to find out about your child’s general health, previous experiences of anaesthesia, any medicines your child is taking and any allergies he or she might have.

This is a good time to talk about any previous experiences your child has had with injections or hospitals, or any particular concerns you have about this hospital visit. You may find it helpful to make a list of questions you want to ask. Questions you may like to ask your anaesthetist could include:

  • Who will give my child’s anaesthetic?
  • What type of anaesthetic do you recommend?
  • Have you often used this type of anaesthetic?
  • What are the risks of this type of anaesthetic?
  • Does my child have any special risks?
  • How will my child feel afterwards?

For practical reasons, the anaesthetist who comes to see you on the ward may not always be the same one who gives your child’s anaesthetic, but the information you give them will be passed on.

Delaying the operation or investigation

Occasionally the anaesthetist may learn something about your child that means it would be safer not to do the procedure on that day.

This could happen if your child has a bad cold, has a rash or has eaten food too recently.

Nothing to eat and drink – fasting (‘nil by mouth’)

Your admission letter will give you clear instructions about fasting – not eating or drinking. It is important for your child to follow these.

If there is food or liquid in your child’s stomach during the anaesthetic, it could come up into the back of the throat and damage the lungs.

Pre-medicationShow [+]Hide [-]

Premedication (a premed) is the name for drugs that are sometimes given before an anaesthetic, although today they are given less often. Some premeds help your child to relax, and some are related to the kind of surgery he or she will be having.

Not every child needs a premed. Depending on the kind of surgery and your child’s condition, you will often be able to help decide, with the anaesthetist, whether your child needs a premed or not.

If your child does need a premed, this will usually be given as a liquid. Occasionally an injection is essential.

Premeds are given some time before the anaesthetic. They may make your child drowsier afterwards and if you plan to go home on the same day, this may be delayed.

The drugs used can be:

  • sedatives to ease your child’s anxiety
  • pain relieving drugs such as paracetamol that can help at the end of the procedure
  • medications to protect your child from side effects of the anaesthetic (for example, nausea)
  • an extra dose of treatment for illnesses like asthma.

Going to the operating theatreShow [+]Hide [-]

Depending on the procedure or operation, your child may be able to wear his or her own clothes to the operating theatre, but if not we will provide your child with a colourful gown. Your child will be able to keep underwear on.

Your child may travel to the anaesthetic room in a bed, on a trolley, walking or being carried.

Rooms used for operations

  • Anaesthetic room – the room next to the operating theatre where anaesthetics are usually administered.
  • Operating theatre – the room where surgery is performed. If your child is very small, or is having certain kinds of surgery, it may be safer to give the anaesthetic in the operating theatre rather than in the anaesthetic room.
  • Recovery room – a place near the operating theatre where children go after surgery until the effects of the anaesthetic drugs wear off.

In the anaesthetic room

A nurse from the ward will accompany you to the anaesthetic room. Your child will be able to take a toy or comforter.

If you wish, one parent will usually be welcome to stay with your child until he or she is unconscious. However, there are a few circumstances when this will not be possible - the anaesthetist will discuss this with you. It may be possible to give the anaesthetic while your child is sitting on your lap. Your child can either have an anaesthetic gas to breathe or an injection through a cannula (a thin plastic tube that is placed under the skin, usually on the back of the hand. A needle is used to put the cannula in, but is then immediately removed. A cannula can be left in place for hours or days so that drugs and fluids can be given without the need for further injections. Sometimes blood samples can be taken through a cannula.)

Some children prefer gas and some prefer injections. If both methods are safe for your child, you may be able to choose which is used.

Anaesthetic gases smell similar to felt-tip pens. The anaesthetist generally cups a hand over the child’s nose and mouth or uses a facemask to give the anaesthetic gas.

If the anaesthetic is given by gas, it will take a little while for your child to be anaesthetised. Your child may become restless as the gases take effect. A cannula will then be inserted when your child is asleep. If you have any questions, please ask the anaesthetist.

If an injection is used, your child will normally become unconscious very quickly indeed. Some parents may find this frightening, but don’t worry, it’s perfectly normal and the anaesthetist will explain what is happening.

What happens next?

Your child will be taken into the operating theatre to have the operation or investigation. The anaesthetist will monitor your child’s blood pressure, pulse, temperature and breathing closely throughout the procedure, ensuring that he or she is safe and fully unconscious. Anaesthetic gases and/or drugs given into a vein will be used to keep your child anaesthetised.

After surgery

Most children go to a recovery room. Each child is cared for by a specialist nurse until he or she has regained consciousness and is comfortable enough to return to the ward.

You will be called to the recovery room when your child is waking up, or is awake, and can stay with them as they return to the ward. Some children may need to go to the Intensive Care Unit after their operation. This will be discussed with you beforehand if it is planned.

Pain reliefShow [+]Hide [-]

Pain relieving drugs may given during the anaesthetic, if necessary, to ensure that your child is as comfortable as possible after surgery. The type and strength of pain relief given will depend on the procedure.

You will have a chance to discuss and help plan the kind of pain relief (analgesia) your child will receive after their operation.

Ways of giving pain relief

  • Syrups and tablets – just like at home.
  • Melts – medicines that ‘melt in your mouth’ – these are especially suitable for olderchildren.
  • Suppositories – some pain relieving medicines like paracetamol can be given rectally (into the bottom). These are often given while your child is anaesthetised and last for several hours. Suppositories are very helpful when children cannot take medicines by mouth or are feeling sick.
  • Local anaesthetics – these are injected near the nerves around the operation site to numb the area. The injections are given while your child is anaesthetised and the pain relief lasts for several hours.
  • Strong pain relieving drugs – such as morphine can be given in many different ways.

Common terms used with medicines

  • IV – intravenous – when drugs are given into a vein through a cannula.
  • IM – intramuscular – when drugs are given by injection into the muscles of thebottom or upper arm.
  • S/C – subcutaneous – when drugs are given just under the skin, either as a ‘one off’ or through a cannula.
  • Infusion – when drugs are administered continuously, usually by a special pump.
  • PCA – Patient Controlled Analgesia – an infusion of pain relieving drugs controlled by a pump with a button your child can push when extra doses are needed.
  • Epidural – an injection or infusion of local anaesthetic around the spine – used after major surgery.
  • Caudal – an injection of local anaesthetic near the nerves as they leave the spine, similar to an epidural.

Going homeShow [+]Hide [-]

Most children have their investigations or operations carried out as ‘day case’ patients and go home on the same day. They may experience some pain or discomfort on the first day or so.

The ward staff may give you pain relieving medication to take home with you and explain how this should be taken. It is a good idea to have some paracetamol or ibuprofen at home, ready for your child’s discharge.

Occasionally children may feel sick after they have left hospital, or even vomit. This sometimes happens in the car on the way home.

Sometimes children do not sleep well after a stay in hospital. Their behaviour might be a little bit more clingy or difficult than before. This is a normal reaction to a stay in hospital, and will usually return to normal within three to four weeks.

If you have any concerns about your child when you get home, you should contact the hospital using the telephone number provided.

 

Side effects and complicationsShow [+]Hide [-]

In modern anaesthesia, serious problems are uncommon. Risk cannot be removed completely, but modern equipment, training and drugs have made it a much safer procedure in recent years.

Most children recover quickly and are soon back to normal after their operation and anaesthetic. Some children may suffer side effects like sickness or a sore throat. These usually last only a short time and there are medicines available to treat them if necessary.

The exact likelihood of complications depends on your child’s medical condition and on the nature of the surgery and anaesthesia your child needs. The anaesthetist can discuss this with you in detail at the pre-operative visit.

For a child in good health having minor surgery:

  • 1 child in 10 (like one person in a large family) might experience a headache, sore throat, sickness or dizziness.
  • 1 child in 100 (like one person in a street) might be mildly allergic to one of the drugs that has been given.
  • 1 child in 20,000 (like one person in a small town) might develop a serious reaction (allergy) to the anaesthetic
(like one person in a large family) might experience a headache, sore throat, sickness or dizziness.

Throughout the whole of life, an individual is at least 100 times more likely to suffer serious injury or death in a road traffic accident than as a result of anaesthesia.

More information

You can see a virtual tour of the facilities that children may see when they come into hospital on our Ward 8 webpage.

You can find out more about anaesthetics and your child at:

For details about you child's treatment, please phone the contact number on the admission letter, or ring the Switchboard on:

  • Tel: 0191 233 6161

For more details about Children's Service at the Great North Children's Hospital, please contact us. 

Leaflet to download

You can download the information on this page as a PDF document.pdf

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