Surgery can be an anxious time for you and your child. You both will meet many doctors, nurses and other people who will do their best to make your experience a positive one. Just as there are doctors who specialize in different aspects of a child’s hospital care, such as pediatricians and surgeons, anesthesiologists are doctors with special training in the anesthetic and pain management care of children.
What Do Anesthesiologists Do?
The Anesthesiologist's main task is to keep your child safe and comfortable in the operating room and even after surgery. They will help to make the entire hospital stay as pleasant and comfortable as possible. During the surgery the anesthesiologist is responsible to keep your child asleep or the area of the surgical procedure insensible to pain. Additionally, the anesthesiologist watches your child very closely for changes in heart rate, breathing, blood pressure and reacts to them to keep your child safe. Apart from this, anesthesiologists are specially trained to make the operative procedure as comfortable as possible for your child.
Anesthesiologists know how children react to hospitals and surgery. As physicians, they work with other doctors to improve the quality of your child's hospital stay.
After the surgery, anesthesiologists are often involved in providing pain relief for your child and are consulted by other doctors in the hospital. Even if your child is not undergoing a surgical procedure, an anesthesiologist may be consulted for pain management, respiratory care and other medical problems.
How Can I Help?
The anesthesiologist and surgeon will do their best to make your child's visit to the hospital as pleasant as possible, but you have a key role in your child's care. It is important for you to prepare your child for the operation as soon as the decision is made to perform surgery. Get informed about the procedure. Explain to your child why he or she needs the procedure and emphasize the positive. Tell your child that he or she will not be alone, and the anesthesiologist is there to keep them safe. When he or she wakes up, it will be in a different place than where the child went to sleep. The child may be sleepy and sore. Reassure him or her that the doctors and nurses will help the child feel better. Additionally, let them know that you are close even if the child cannot see you and that someone will go get you when they wake up.
Your composure as a parent is essential. Nothing calms a child more than a confident parent. Although it is natural for parents to be anxious when their child is having surgery, try not to show it.
What Will the Anesthesiologist Need to Know?
The anesthesiologist will want to make sure your child is in the best possible physical condition before surgery. You will be asked important questions about your child’s general health, such as:
- Does your child have allergies or asthma?
- Is there a family history of difficulties with anesthesia?
- What are your child’s previous experiences with anesthetics.
During this evaluation, the anesthesiologist will explain the planned anesthetic procedures. The discussion may include whether or not your child will receive anything for sedation before surgery, how the anesthetic will be initiated and maintained, and other pertinent anesthetic details. This is the best time for you and your child to ask questions and express any concerns to the anesthesiologist.
Sometimes minor illnesses such as a cold may cause problems during some types of surgery and anesthesia. For this reason, the anesthesiologist may feel it is best to postpone surgery. Remember, even though this can be an inconvenience, the anesthesiologist has your child’s safety in mind.
What If My Child Has Outpatient Surgery?
Outpatient surgery for certain operations has become very common and can be performed without a hospital admission. This means that information about your child needed by the anesthesiologist will be obtained the day of surgery or at some meeting arranged before the day of surgery. Although outpatient or same-day surgery is usually performed for “small” operations, the anesthesia is never “small.” It is just as important to follow preoperative directions for outpatient surgery as for operations when your child is brought into the hospital overnight. For example, it is very important for your child’s safety to follow closely the anesthesiologist’s instructions concerning food and liquid intake.
How Will My Child Be Given Anesthesia?
Anesthetic agents can be administered in several ways. In adults, most commonly an intravenous line is started preoperatively and the anesthetic initiated with intravenous agents. This method can also be used for children. Another method is to let your child breathe anesthetic agents through a mask quietly, and let them drift off to sleep. No needle sticks are required until after your child is asleep. The choice on which method will be used for your child will be made by the anesthesiologist based on many factors. He or she will also determine if your child should receive a sedative prior to going to the operating room to make the separation from you easier. This medication can be given by mouth, injection or rectal suppository.
Will There Be Any Side Effects?
Although anesthetics can provide complete pain relief and loss of consciousness during an operation, they do occasionally have side effects. They tend to decrease breathing, heart action and blood pressure. The anesthesiologist is specially trained to ensure that these effects are minimized. Although operations are very safe, they still produce stress on the body and may cause your child to have a “sick” feeling. Nausea and vomiting are occasional side effects after surgery and anesthesia.
How Long Will My Child Be Asleep After Surgery?
Children awaken from anesthesia at differing rates. Some children may be fully alert upon arriving in the recovery room. Others may be groggy for hours after surgery. If you have any questions about your child’s recovery, feel free to ask your anesthesiologist.
What About Regional Anesthesia for My Child?
In recent years, it has become possible to provide pain relief to specific areas of the body rather than give general anesthesia that causes unconsciousness. For example, if your child is having foot surgery, it is possible to eliminate the feeling of pain in only the foot, either with a local injection of an anesthetic or by regional anesthesia. The most common type of regional anesthesia used in children is called epidural anesthesia. This is very similar to the anesthesia used for childbirth when local anesthesia is injected into the back or tailbone region. Intravenous sedation or inhaled anesthetic agents may be combined with a regional anesthetic. This combination may allow the anesthesiologist to give less general anesthesia. Another advantage is that regional anesthesia often is used to provide pain relief after surgery. Your anesthesiologist can discuss the advantages and disadvantages of regional anesthesia with you.
How Is Pain Controlled After Surgery?
The anesthesiologist may be consulted to help manage your child’s pain following the surgery. Although injections still are commonly used, other forms of pain management may also be chosen to provide comfort. For instance, patient-controlled analgesia (PCA) allows a child to self-administer a controlled dose of pain-relieving medicine when needed. A small, computerized pump is programmed by the anesthesiologist, and some children may be instructed on pump use depending on the circumstance.
Another approach is the insertion of a tiny epidural catheter in your child’s back through which a small dose of medication for pain relief can be given. This allows the child to be more awake and lessens the chance for complications from the use of other pain medications. Sometimes, the epidural pain relief can be continued for several days after the operation.
You've Taken the First Step. Keep Going.
Surgery is never easy for a family, especially when the patient is a child. Reading this information is a good first step in getting prepared. Continue trying to inform yourself and work with the surgical team to get your child ready for what will hopefully be a successful outcome.