Anaesthesia for kids

Anaesthesia in children is very safe, and is performed successfully hundreds of times each day around Australia.  Your anaesthetist is a highly skilled and vastly experienced practitioner – your child is in good hands.

When your child needs an operation, this can be stressful for both parent and child.  First time parents particularly can find the situation upsetting.  It is normal to be nervous and worried before your child is put to sleep, but it is important to try not to convey this to your child  – calm parent usually equals calm child and vice versa.

Children vary greatly in their response to the theatre surroundings.  Some are happy from start to finish, and accept the anaesthetic mask without a fuss.  At the other end of the spectrum, a child may need to be forcibly restrained to bring them to theatre!  We have seen every situation, and have extensive experience in managing even the most combative child.
It can be very upsetting and traumatic for a parent when their child goes to sleep distressed.  However, please bear in mind that an upset child during the induction of an anaesthetic is very common, in many cases unavoidable, but while upsetting, does not pose a health risk to your child.  They will eventually go to sleep, and the operation will take place.  Be prepared for a few tears – your child and perhaps yourself!

For more information, click on the links below or call us.

Can I come into the operating theatre?

One parent is encouraged to come into theatre with your child to comfort and reassure them until they are asleep. You may be asked to hold your child in your lap or lie down next to your child as they go to sleep, every anaesthetist has their own ideas on what works well so you may have a variety of different experiences.

Once your child is asleep, you will be taken out of the theatre to an area where you can wait.  You will not be able to stay in the theatre after your child is asleep.

What happens in the operating theatre?

After your child has been checked by the theatre staff, they will be taken into the operating room.

Most children go to sleep by breathing in anaesthetic gases that are administered through a clear, sweet smelling mask. The advantage of this is that it avoids having to give your child a needle while they are awake. Your child will have a drip, but it will be put in after they are asleep.

The main disadvantage of the gas is that it can take some time, up to a minute before your child loses consciousness. The mask also needs to be gently but firmly applied so as to maximise the amount of anaesthetic your child is breathing in.

You may find that initially your child happily breathes on the mask, but then becomes upset after a short time. This is because the anaesthetic they receive is pungent and unpleasant, and it is this smell that they are often reacting to.

What happens after the operation?

When your child’s surgery is completed, they are transferred on a bed to the recovery room where they will be continuously monitored by recovery nurses until they are awake.  Once the recovery nurses are happy that your child is stable and comfortable, they will usually call for you to be with your child. It is very common for younger children to be crying even if they are not in pain or discomfort. It is more a reaction to their abrupt wake up and the strange surroundings they are in.

When your child is awake and comfortable, you and your child will return to the ward. Your child will have medication available to take in the ward for pain and nausea, and may still have a drip connected.

Premedications

A drink containing a premedication given to your child before their operation can help, and is used in a minority of cases. If you think your child will be excessively anxious and uncooperative, a premedication may be useful in making him or her sleepy before the procedure. This can be particularly useful if during a previous operation, your child has strongly resisted the anaesthetic and threatens to do so again.

Please let your anaesthetist know if you think your child might benefit from a premedication, as this needs to be arranged in advance, and given 20-40 minutes prior to it being required. Premedications are given on a by weight basis, so as to not overdose your child. Having said this, their response is variable also, and you may find on rare occasions that the premedication has had only a minor effect on your child. The premedication given has a long effect, so having one may delay their wake up in the recovery room.

What can I do to help my child?

Children are generally less stressed on the day of surgery if they are given information beforehand, however the benefit of this depends very much on the child and the age they are when they have their operation.  Your anaesthetist will give you information regarding your child’s anaesthetic, and suggest things to discuss with your child in order to reduce their anxiety on the day.  For example, they may suggest you tell your child that they will be breathing on a special ‘space mask’ that smells like strawberries, and that they get to take the mask home with them.  Or they may suggest telling them that the mask will make them go to sleep so they can have their operation done without feeling anything, and that you will be with them when they wake up.

What happens if my child is sick before the operation?

​​This is common, particularly if your child is having tonsil or adenoid surgery.  Please phone our rooms for advice, usually your anaesthetist will contact you to discuss the situation.

Where possible your anaesthetist will endeavour to proceed with your child’s operation, but your child’s safety will be the primary concern.  Concurrent illness may complicate anaesthesia and surgery, and can increase the risks of post operative problems.

My child is having a tonsillectomy

A tonsillectomy, or adenotonsillectomy is a very common operation in children, and is usually done either because your child has issues with recurrent tonsillitis, or has sleep apnoea.

Your anaesthetist will want to know the reason for your child’s operation, and particularly if your child has severe sleep apnoea.  Signs of severe sleep apnoea are daytime sleepiness, and particularly if your child sleeps on their back with their mouth open.  Severe sleep apnoea presents a slightly increased risk of complications post operatively, and needs to be managed very carefully.

Your child will most likely stay overnight, to monitor for any issues including bleeding.  Tonsillectomies can be quite painful, and your child may need a combination of pain relieving medications for up to 2 weeks.  These medications will be organised for you prior to discharge.  DO NOT use Painstop (codeine) for your child if they have had a tonsillectomy.

Patient checklist