Does the idea of your baby, toddler or child needing anaesthesia for a medical procedure fill you with anxiety?
Well, you would not be human if you didn't have a mountain of questions.
Dr Clover-Ann Lee is a specialist paediatric anaesthetist and Head of Anaesthetics at Joburg's Nelson Mandela Children's Hospital.
She has answered some of the most common questions parents ask about anesthesia in kids.
What is a general anaesthetic?
A general anaesthetic is medication given to children so they cannot see, hear or feel anything during a medical procedure.
An anaesthetist administers it (sometimes called an anesthesiologist): a specialist doctor who also takes care of your child during the procedure.
Their role is to make sure your child is comfortable and well throughout the procedure, and their pain is well managed and kept to a minimum.
What’s the role of the anaesthetist?
Every person in the operating theatre is invested in your child’s health and safety.
The anaesthetist is the person who makes sure everything goes well: that your child gets ample oxygen, that their blood pressure stays stable, and that they do not awaken during the procedure.
You will probably meet the doctor, surgeon or physician before the big day.
However, you may only meet your child’s anaesthetist on the day of their procedure.
The surgeon is responsible for the outcome of the procedure. But overall, the safety of the patient is the primary responsibility of the anaesthetist.
How can I prepare my child for receiving an anaesthetic?
It depends a lot on how old your child is.
Teens and tweens benefit from as much information as you can give them.
All children (from babies to teens) need to know what to expect, and that you'll be there to help them through the experience.
Talk to your child in words and language they understand.
For young children, it's enough to say that the doctor is going to give them a particular medicine that will make them fall asleep.
The medical team will be dressed in the theatre gear when the child is taken into the theatre.
Prepare them for this, as they will be expecting to see the familiar face of their doctor.
Tell them the doctors will be wearing pyjamas and will look silly.
Also, tell them the doctors wear certain clothes to make sure there are no bad germs in the room.
They are there to keep them safe.
Reassure them that you will be there at the time they go to sleep, and also when they wake up.
Prepare them by telling them they might feel a bit to feel uncomfortable when the wake-up, but the doctor has medicine for that.
Children who know what to expect tend to manage the experience of anaesthesia well.
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What about food and liquid? What’s safe and what isn’t?
Please follow the instructions the doctor provides to you in a letter.
The protective reflexes that prevent food in our stomachs from coming up and going into our lungs are relaxed under anaesthesia.
This is why your child's stomach must be empty before an anaesthetic.
Generally, offer a light meal or formula feed no less than six hours before anaesthetic.
Breastfeeding is okay no less than four hours before anaesthetic and sips of clear, non-fizzy liquid are okay no less than two hours before anaesthetic.
To make it easier on your child, please don't eat or drink in front of them when they are not allowed to have food or drinks.
What can we expect once we get to the hospital?
Your child’s anaesthetist will visit you and your child in the ward before the procedure.
They'll ask a few questions.
It’s important to answer all these questions honestly.
It’s especially important to tell the anaesthetist if your child has had the flu or a cold in the last few weeks.
This is also a great opportunity to ask the anaesthetist any questions or tell them about concerns you may have.
This will help you feel more relaxed, and a relaxed parent ensures a calmer kid!
What happens in the operating theatre?
Rest assured that the medical team will take good care of your child.
General anaesthetic medicine is either injected into a vein or given as a gas that’s administered by a mask placed over your child’s nose and mouth.
The anaesthetist will be with your child throughout the procedure, making sure they remain asleep, monitoring then continuously and giving whatever fluid, medication and pain-relieving medicine they require.
Can I go into the operating theatre with my child?
In most cases, one parent is welcome to accompany their child into theatre.
But it’s fine, too, if you’d rather not go into theatre with your child.
Your child will drop off to sleep really quickly once the anaesthetic drugs kick in.
Then you’ll be asked to leave the theatre to let the doctors get on with their work.
If you do go into theatre, you can bring their favourite snuggly toy or blankie to reassure them.
Distracting games on an iPad or phone are great, too.
You are also welcome to chat to your child as they fall asleep.
A parent’s reassuring chatter distracts the child while the anaesthetic takes effect.
It’s a good idea to be there when they regain consciousness, so wait outside the recovery room so you can be called when they are fully conscious and need your presence and support.
And afterwards? What should we expect then?
They might seem disoriented and upset for a few moments.
This is normal.
Reassure them that everything’s fine, and offer them a toy, blanket or dummy perhaps if they are still a baby.
Disturbed sleep patterns for a few days after anaesthetic are quite normal.
This should settle down soon.
When is it safe to give them something to eat and drink after anaesthesia?
This largely depends on the kind of operation your child had, and your surgeon should guide you through this.
After most minor procedures(hernia repairs, tonsillectomies and grommets, for example) they'll be able to drink as soon as they are awake enough.
The key is to let them have whatever they feel like, but not to push it.
Children know how they feel and might get sick if they eat and drink too much too soon.
Are there any side effects and complications to look out for or worry about?
Most side effects of anaesthesia are mild and will sort themselves out in a matter of hours or (at worst) a day or two.
These could include nausea, a sore throat and a headache.
Depending on the surgery and the pain-management medication that's been prescribed, your child may also feel a little out of sorts for a few days and need more or longer daytime naps than usual.
This, too, will settle down after a few days.
Call your doctor if there's anything you're worried about, or if something doesn't seem right to you.
Seriously, what’s the risk?
While there's no guarantee that they're risk-free, anaesthetics are generally very safe.
Modern anaesthetic techniques, medication, monitoring and training continue to make anaesthesia safer.
Are you still a bit anxious about anaesthetics?
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