If your child needs surgery or a medical test that requires anesthesia, you may have many questions. One of the most common concerns — for both young patients and their parents — is the use of anesthesia. Parents often ask: How will my child respond to the medication? How do I keep myself calm to reassure my child?
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Fortunately, anesthesia is very safe, and knowing what to expect can put you and your child at ease, says pediatric anesthesiologist Pilar Castro, MD.
How to prepare before surgery
Getting your child and yourself ready for your child’s surgical procedure can start well before the day of the surgery. Here are three important tips:
- Read the paperwork. Review the information you’ll get from your child’s treatment team.
- Take a tour. Most children’s hospitals will give you and your child an individualized preoperative tour. This helps young patients become familiar with their surroundings and helps them feel more comfortable.
- Explain what’s happening. Dr. Castro recommends talking to your child in an age-appropriate manner about what to expect. “It’s important for parents to explain what’s going to happen in a reassuring way,” she says. You also need to decide how far in advance to tell your child, based on their age and temperament.
Children have vivid imaginations and can conjure up fears that would never occur to adults. Answer questions honestly, so that your child knows what to expect.
What to expect on the big day
On the day of surgery, the medical team will help your child feel comfortable. These are some things you can prepare for:
- A hungry, possibly cranky child. Anesthesia requires restrictions on eating and drinking; typically, your child won’t be able to have anything besides clear fluids for eight hours before the surgery. Be prepared for the crankiness that might ensue and reassure your child that, in most cases, she’ll be able to eat and drink not too long after surgery.
- A final check before surgery. Once you’re in the preoperative area, you’ll meet with the medical team. They’ll confirm your child’s identity and review the details of the surgery, including the type of anesthesia and plans for recovery after the surgery is done. At this time your child’s anxiety might really start to spike. But this is also where doctors and nurses can help.
- Medication and other comforts to help your child relax. “One thing we do is to offer some medication by mouth to ease anxiety once they’re in the preoperative area,” says Dr. Castro. “It takes five to ten minutes to act.” Medication isn’t the only thing the medical team has to offer, though. “We use iPads to show them a movie or let them listen to music, and we allow them to bring stuffed animals. You’ll also see us playing with the children, singing with them or talking about their favorite cartoon character — whatever it takes to make them feel safe and comfortable,” she says. Once your child moves to the operating room, it’s time to start the anesthesia.
- A mask to help put your child to sleep. “If they’re going to go to sleep via a mask induction, we use a mask that delivers anesthetic gas that gets them off to sleep completely, and then we’ll start an IV,” explains Dr. Castro. “This way, the child is not awake and they don’t feel any pain while we place the IV. Once they’re older, many children prefer to go to sleep with an IV, because it’s faster,” she says. Parents often accompany their children all the way to the operating room. If you’re in the operating room with your child, prepare for the sight of your child going to sleep. Some parents find this upsetting, Dr. Castro says.
What happens after surgery?
Once surgery is done, the team will take your child to the recovery room. You can come in right away so that you are nearby when your child wakes up. Be prepared for the following:
- A confused and agitated child. “Some children wake up very nicely and peacefully,” says Dr. Castro. “But sometimes they wake up agitated and confused — especially kids under 5 years old. This is called ’emergence delirium,’ and affects about 10 percent of patients.” Patients with emergence delirium are often disoriented upon waking, but this passes within a few minutes, she says.
- A hungry and thirsty child. It’s usually OK for your child to eat and drink at this point, and nurses are nearby to assist with the management of any pain that may occur.
Surgery always creates anticipation for children and parents alike. But knowing what to expect and how to prepare your child can help make it a smooth experience for all of you. And don’t be afraid to ask your child’s medical team if you need more information — they’re there to help.