ANAESTHESIA & CHILDREN

As a father of six young children, I understand the anxiety you and your child may feel in the lead up to surgery. I take great satisfaction in providing you both with a safe and satisfying experience.

How can I manage my child’s anxiety?

Children are generally calm if their parents are calm. I place importance on parental education, as an effective way to manage their child’s anxiety. I recommend that you are honest with your child about their surgery and anaesthesia. This will involve explaining what you know to them (at an age-appropriate level) at least a few days ahead.

The following information should assist.

What can my child and I expect?

Before Surgery:

After you are checked into the hospital, I will meet you and your child in the preoperative ward to outline and confirm the anaesthesia plan. Your child may become anxious and uncooperative. My nursing staff and I are experienced in settling your child, and we ask for your trust.

You have the option of being present with your child at the start of anaesthesia. There is no hard and fast rule. I recommend that you do whatever makes you and your child feel more comfortable.

Going to sleep:

I generally initiate anaesthesia in younger children (< 10 years) with anaesthetic gas, delivered through a clear mask which covers their nose and mouth. This is not painful, and I use techniques to gain your child’s cooperation.

In older children (>10 years), I usually initiate anaesthesia with an intravenous injection. A local anaesthetic cream may be applied to their hands, allowing painless insertion of an intravenous cannula (‘drip’) to commence their anaesthesia.

You may stay with your child until they are asleep. However, once this occurs, you must leave quickly, as the deepening of anaesthesia requires greater vigilance. As your child is drifting off to sleep, they may display normal signs of anaesthesia which include: combative behaviour, shaking of limbs, rolling of their eyes, and snoring. Please do not be alarmed. It is important you remain calm during this period as my attention is completely on your child and their safety.

After Surgery:

When surgery is complete, I will bring your child to the recovery area, where they will gradually wake up in the care of specially trained nurses. Most children wake up comfortably, but some may be distressed, usually due to disorientation.

Children may experience some side-effects from the surgery which include:

• nausea and vomiting;

• sore throat;

• bruising; and

• pain.

My nursing team and I will treat any of these side-effects, and only discharge your child from recovery when they are comfortable. Parents are generally not allowed in the recovery area, but we may occasionally call for you if we think this will help settle your child. Either myself or your child’s surgeon will speak with you after the surgery.

How do I prepare my child for surgery?

1. Communication: I suggest explaining to your child what they can expect (from the information above) in age-appropriate language. I am very happy to assist with this over the phone on request through a pre-operative assessment call.

2. Fasting: please strictly follow the hospital’s instructions on fasting. If you do not hear otherwise, please following these guidelines before the procedure:

   • No eating or drinking for 6 hours

   • No breastmilk for 4 hours

   • No clear fluids (water, apple juice) for 2 hours prior

3. Medications: Please bring all your child’s medications to hospital. Your child should take all their regular medications up to and including the day of your surgery (with a small sip of water). If they are on diabetes or blood thinning medications, please contact me for specific advice, as these medications may be exceptions to the above instructions.

Please note: Sometimes your procedure will have specific fasting instructions given by your child’s surgeon (e.g. colonoscopy). Those instructions take priority over my general fasting instructions listed above.