No doubt about it, getting an operation can be stressful for
kids and adults alike. If your child is scheduled for
surgery
, you may have questions or concerns about anesthesia, in
particular. The thought of your child being unconscious or
temporarily losing sensation can be downright unnerving, whether
your little one is 7 months or 17 years old.
From a minor procedure with a shot to numb the area to a more
serious surgery in which your child will be "asleep,"
knowing the basics about anesthesia may help answer your questions
and ease some concerns - both yours and your child's.
About Anesthesia
Basically, anesthesia is the use of medicine to prevent the
feeling of pain or sensation during surgery or other procedures
that might be painful (such as getting stitches or having a wart
removed). Given as an injection or through inhaled gases or vapors,
different types of anesthesia affect the nervous system in various
ways by blocking nerve impulses and, therefore, pain.
In today's hospitals and surgery centers, highly trained
professionals use a wide variety of safe, modern medications and
extremely capable monitoring technology. An
anesthesiologist
is a doctor who specializes in giving and managing
anesthetics
- the medications that numb an area of the body or help your child
fall and stay asleep. A pediatric anesthesiologist has specialized
training that certifies him or her to care for children.
In addition to administering anesthesia medications before the
surgery, the anesthesiologist will:
- monitor your child's major bodily functions (such as
breathing, heart rate and rhythm, body temperature, blood
pressure, and blood oxygen levels) during surgery
- address any problems that might arise during surgery
- manage any pain your child may have after surgery
- keep your child as comfortable as possible before, during,
and after surgery
A specially trained
nurse anesthetist
or resident physician, who works with the anesthesiologist and
surgeon, may also assist with giving your child anesthesia
(although the anesthesiologist will be the one to manage the
anesthesia and make all major anesthesia-related decisions during
the operation).
Types of Anesthesia
Anesthesia is broken down into three main categories: general,
regional, and local, all of which can be administered using various
methods and different medications that affect the nervous system in
some way. The American Society of Anesthesiologists (ASA) compares
the nervous system to an office's telephone system - with the
brain as the switchboard, the nerves as the cables, and the body
parts feeling pain as the phones.
General anesthesia.
The goal is to make and keep the person completely unconscious (or
"asleep") during the operation, with no sensations,
feeling of pain, awareness, movement, or memory of the surgery.
General anesthesia can be given through an IV (which requires a
needle stick into a vein, usually in the arm) or by inhaling gases
or vapors.
Regional anesthesia.
An anesthetic drug is injected near a cluster of nerves, numbing a
larger area of the body (such as below the waist). A child who
receives regional anesthesia is usually asleep before the procedure
is done. However, older kids or those who would be at unacceptable
risk by being asleep may be awake or sedated during the procedure.
For example, if a child is overweight, it may be difficult for the
anesthesiologist to feels the bones that help guide correct
placement of the needle. To avoid nerve damage, getting
feedback from an awake child would be a safer option.
Local anesthesia.
An anesthetic drug numbs only a small, specific part of the body
(for example, a hand or patch of skin). Depending on the size of
the area, local anesthesia can be given as a shot, spray, or
ointment. With local anesthesia, a person may be awake or sedated.
Local anesthesia lasts for a short period of time and is often used
for minor surgeries and outpatient procedures (when patients come
in for an operation and can go home that same day). If your child
is having surgery in a clinic or doctor's office (such as the
dentist or dermatologist), this is probably the type of anesthetic
that will be used.
Anesthesiologists may also give children a sedative to help them
feel sleepy or relaxed before giving a general, regional, or local
anesthetic. Why? Because many kids are afraid of needles and young
children may have a hard time staying still and calm, so doctors
may need to help them relax first. That way, kids
typically just need to breathe themselves to sleep by inhaling
into a mask, which may help ease some anxiety about needles and the
overall procedure or surgery.
The type and amount of anesthesia will be specifically tailored
to your child's needs and will depend on various factors,
including your child's age and weight, the type and area of the
surgery, any allergies your child may have, and your child's
current medical condition. You and your anesthesiologist can decide
what's best for your child.
Common Side Effects
Your child will most likely feel disoriented, groggy, and a
little confused when waking up after surgery. Some other common
side effects, which should go away fairly quickly, include:
- nausea or vomiting, which can usually be alleviated with
anti-nausea medication
- chills
- shakiness
- sore throat (if a tube was used to administer the anesthesia
or help with breathing)
What Are the Risks?
Anesthesia today is very safe. In very rare cases, anesthesia
can cause complications in children (such as strange heart rhythms,
breathing problems, allergic reactions to medications, and even
death). However, rare complications usually involve patients with
other medical problems. The risks depend on the kind of procedure,
the condition of the patient, and the type of anesthesia used. Be
sure to talk to your child's doctor, surgeon, and/or
anesthesiologist about any concerns.
Most complications can usually be prevented by simply providing
the anesthesiologist with complete information before the surgery
about things like:
- your child's current and past health (including diseases
or conditions such as recent or current colds, or other issues
such as snoring or depression)
- any medications (prescription and over-the-counter),
supplements, or herbal remedies your child is taking
- any allergies (especially to foods, medications, or latex)
your child may have
- whether your child smokes, drinks alcohol, or takes any
recreational drugs (this usually applies to older teenagers)
- any previous reactions your child or any family member has
had to anesthesia
To ensure your child's safety during the surgery or
procedure, it's extremely important to answer all of the
anesthesiologist's questions as honestly and thoroughly as
possible. Things that may seem harmless could interact with or
affect the anesthesia and how your child reacts to it.
It's also important that your child follow the doctor's
recommendations about what not to do before the surgery. Your child
probably won't be able to eat or drink (usually nothing after
midnight the day before) and may need to stop taking herbal
supplements for a certain period of time before surgery.
The thought of surgery and anesthesia can certainly be scary for
parents and kids alike. But you can rest assured that the safety of
anesthetic procedures has improved a lot in the past 25 years,
thanks to advances in technology and the extensive training
anesthesiologists receive. The more informed, calm, and reassuring
you are about the surgery and the safety of anesthesia, the easier
the experience will probably be for both you and your child.
Reviewed by:
Judith A. Jones, MD
Date reviewed: April 2009
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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