During surgery, an anesthesiologist will give your child a form of medication — called anesthesia — to keep him from feeling pain and sensation during surgery. Prior to separating from you, your child may be given a sedative as well. The anesthesiologist will determine the right type and dosage of anesthesia for your child, based on his medical condition and history.
Types of anesthesia
General anesthesia will make your child unconscious during surgery. She'll either inhale the anesthesia through a breathing mask or tube or receive it through an intravenous (IV) line — a thin plastic tube inserted into a vein. For children who are getting their anesthesia through a mask, we offer "flavors" (such as cherry, banana and bubble gum). Your child will sleep through the procedure and wake up with no memory of what happened.
The anesthesia team is prepared to prevent as many side effects as possible, such as temporary slowing of breathing and heart rate and lowering of blood pressure. If your child is under general anesthesia, she may need a breathing tube inserted into her windpipe so she can breathe properly during surgery. It's important to remember that surgery stresses the body and may cause your child to become nauseous and/or vomit when she wakes up. These are normal side effects after surgery and anesthesia.
Regional anesthesia provides pain relief to specific areas of the body, similar to the medicines used by the dentist before dental work. It doesn't make your child unconscious. Often, general anesthesia is used with regional anesthesia, permitting the anesthesia team to give less general anesthesia to your child. Your anesthesiologist and surgeon will be glad to discuss the pros and cons of each kind of anesthesia with you
There are several types of regional anesthetics:
- Spinal anesthetics, which are often used for lower abdominal, pelvic, rectal or lower extremity surgery. The anesthesiologist injects a single dose of the anesthetic directly into the spinal fluid in the lower back, causing numbness in the lower body.
- Caudal and epidural anesthetics, which are similar to spinal anesthetics, are also commonly used for lower limb surgery. The anesthesiologist either gives this anesthesia as a single injection or infuses it continually through a thin catheter (hollow tube) placed into the space surrounding the spinal cord.
- Peripheral Nerve block, where only the nerves controlling sensation to a specific area are numbed. This may be done for surgery on the extremities, such as an arm or leg. Depending on the surgery, this may be done as a single injection or a continual infusion through a thin catheter (hollow tube) placed into the space surrounding the nerve.
Local anesthesia will numb a specific site or area when injected, for example, numbing the wound so that it hurts less after surgery.
Once the surgery is over, the anesthesiologist will adjust the anesthetic so your child will awaken and remain comfortable in the recovery room.
Administration of anesthesia
Anesthesia may be administered in several ways. Mask or inhalation induction allows your child to breathe anesthesia medicines until he or she falls asleep. With this approach, needle sticks are done after your child is asleep. Anesthesia medicines can also be given by intravenous injection, a method which is most often used for adults, but may also be used for older children. Your anesthesiologist will talk to you about the best method for your child.
On the day of surgery, your anesthesiologist will meet with you to discuss the anesthesia plan. You and your child can ask questions and express any concerns at this time.
Your child's anesthesia team
This team is made up of doctors and nurses from CHOP. They specialize in giving anesthesia to children and adolescents. Members of your anesthesia team may include:
- Pediatric anesthesiologist: A doctor who has received advanced education in giving anesthesia to children and adolescents.
- Pediatric nurse anesthetist: A nurse who has received advanced education in giving anesthesia to children and adolescents and works closely with the anesthesiologist.
- Senior anesthesia resident/fellow: A doctor with anesthesia training who is closely supervised by the pediatric anesthesiologist.
- Post-anesthesia care nurses: Nurses who have received special training in the care of pediatric patients receiving anesthesia. They have experience helping children recover after anesthesia.
- Anesthesia technician: A person who helps set up the equipment.
Anesthesia and minor illnesses
Sometimes, minor illnesses, such as the sniffles or colds may cause problems during surgery and anesthesia. In this situation, your anesthesiologist may feel it is best to postpone surgery.
Please notify your surgeon's office if your child:
- Has been exposed to infectious diseases such as measles, mumps or chicken pox
- Has cold symptoms such as a cough, runny nose or fever
- Has any change from his or her usual health
- If your child has had any aspirin or ibuprofen (Advil or Motrin) or products containing aspirin or ibuprofen within two weeks of the surgery