November 30, 2020/Children's Health

Is Anesthesia Safe for Kids?

What parents should know about pediatric anesthesia

child undergoing anethesia in operating room

If your little one needs surgery, odds are good you have many questions — and concerns. Is it really OK to put kids under general anesthesia?

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“Anesthesia is very safe. Parents and families shouldn’t be scared,” says pediatric anesthesiologist Julie Niezgoda, MD.

Still, it helps to understand what’s involved so you can minimize the risks and know what to expect. Here’s what you should know about anesthesia in kids.

Anesthesia safety

Anesthesia is used during surgeries or other medical procedures to sedate patients (put them to sleep) and control their pain. But anesthesia isn’t just one drug. Anesthesiologists use a variety of medications to sedate a patient and control pain.

They carefully adjust the amount of each drug for a child’s age and weight, so kids don’t receive more medication than they need, Dr. Niezgoda explains. And anesthesiologists monitor patients carefully to make sure they stay asleep for the whole procedure and experience as little pain as possible when they wake up.

Anesthesia today is even safer than it was a generation ago, thanks to advances in technology and medication. And it’s getting safer all the time, as more and more specialists train in providing anesthesia to the youngest patients.

“In the last 10 years, more pediatric anesthesiologists have been trained than in the history of pediatric anesthesia,” Dr. Niezgoda says.

Anesthesia risks in children

Overall, anesthesia has a low risk of complications, Dr. Niezgoda says — even in very young children. The most common side effects are relatively mild, such as nausea and grogginess.

The U.S. Food and Drug Administration warns that “repeated or lengthy use” of general anesthetic or sedation drugs in children under 3 may affect brain development. But, says Dr. Niezgoda, these warnings are based on animal studies. There are also many factors that contribute to brain development, which can make it challenging to isolate any potential effects of anesthesia. However, ongoing human studies continue to look at brain development in children exposed to anesthesia multiple times or for longer period of time.

Studies of children with a single exposure to anesthesia are encouraging. One study of healthy children under 3 found that a single exposure to anesthesia did not affect children’s IQ scores later in childhood.

To play it safe, anesthesiology guidelines recommend delaying some elective surgeries until after a child’s third birthday. Parents can push off a cosmetic procedure to remove a birthmark without risk to the baby’s health.

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But in many cases, delaying surgery is riskier than the small risks from anesthesia, Dr. Niezgoda says.

“Putting off surgery to correct an eye misalignment can affect a child’s visual development, and delaying surgery to treat recurrent ear infections could affect a child’s speech and cognitive development,” she explains. “If a child really needs the surgery, there’s no reason to delay.”

How to prepare

For many families, the worry leading up to a child’s surgery is the hardest part. Take some time to prepare so that you can calm the butterflies in your child’s tummy (and your own).

  • Be honest: Explain to your child what to expect before, during and after the operation. Adjust your language depending on your kiddo’s age and vocabulary, but even toddlers deserve to know what’s going to happen, Dr. Niezgoda says. Let your kid ask questions. And encourage them to ask their healthcare team questions, too. “I explain to children that they are in charge of their body. They have the right to ask questions to anyone who is caring for them,” she says.
  • Plan for fear of needles: Lots of kids (and, let’s face it, adults) are anxious about getting a shot. To ease that fear, anesthesiologists can usually let kids fall asleep with gas through a mask before placing the IV. Ask your healthcare team if it’s an option for your child’s surgery.
  • List your questions: Before meeting with your child’s surgery team, write down your questions. Getting your questions out of your head and onto paper helps quiet your brain — and ensures you don’t forget anything. (Pro tip from Dr. Niezgoda: If your child is taking a medication or has an illness that requires them to have blood drawn regularly, ask if that can be done while the child is under anesthesia.)
  • Pack a bag: Let your child pick out a favorite stuffed toy or blanket and a couple of books to bring from home. Beloved, familiar items will provide some comfort and a welcome distraction.

Pediatric anesthesiologists: caring for kids

Not all surgeries require an anesthesiologist that specializes in kids, Dr. Niezgoda says. But if your child is having a lengthy or complex procedure, she recommends discussing with your child’s surgeon whether a pediatric specialist is available.

Anesthesiology researchers are continually innovating to find new and better ways to treat kids, she adds. “Researchers are exploring new and safer drugs that continue to decrease the risk of long-term outcomes in children,” she says. “We’re constantly creating new combinations of anesthetics that are the safest possible based on what we know about the developing brain.”

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