If your child is to undergo a surgery or procedure, it may help
reassure you to understand how the various types of anesthesia
work to make the experience more comfortable.
Anesthesia is broken down into three main categories: general,
regional, and local, all of which affect the nervous system in some
way and can be administered using various methods and different
medications.
Here's a look at what each kind does:
General Anesthesia
The goal is to make and keep a person completely unconscious (or
"asleep") during the operation, with no awareness 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 by breathing into a mask or
tube.
If your child is having general anesthesia, the anesthesiologist
will be there before, during, and after the operation to monitor
the anesthetic medications and ensure your child is constantly
receiving the right dose. With general anesthesia, the
anesthesiologist uses a combination of various medications to:
- relieve anxiety
- keep your child asleep
- minimize pain during surgery and relieve pain afterward
(using drugs called
analgesics
)
- relax the muscles, which helps to keep your child still
- block out the memory of the surgery
After surgery, the anesthesiologist reverses the anesthesia
process to help your child "wake up." It usually takes
about 45 minutes to an hour for kids to recover completely from
general anesthesia. This recovery period is monitored by specially
trained nurses in the post-anesthesia care unit (PACU) or recovery
room. During recovery, your child is still under the care of the
anesthesiologist.
Regional Anesthesia
An anesthetic drug is injected near a cluster of nerves, numbing
a larger area of the body (such as below the waist). Someone 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 person would be a safer option.
In kids, regional and general anesthesia are often combined,
except in very special circumstances. Regional anesthesia is
generally used to make someone more comfortable during and after
the surgical procedure.
If regional anesthesia is appropriate for your child, you'll
discuss this with the anesthesiologist. The time required to
recover from the numbing effect will vary depending on the type of
regional anesthetic used.
Local Anesthesia
An anesthetic drug (which can be given as a shot, spray, or
ointment) numbs only a small, specific area of the body (for
example, a foot, hand, or patch of skin). With local anesthesia, a
person is awake or sedated, depending on what's best for the
patient.
Local anesthesia is often used for minor outpatient procedures
(when patients come in for surgery and can go home that same day).
If your child is having an outpatient surgery or procedure in a
clinic or doctor's office (such as the dentist or
dermatologist), this is probably the type of anesthetic that will
be used. The medicine can numb the area during the procedure and
for a short time afterwards, helping to control discomfort after
surgery. The numbing medicine may wear off in about 2-4 hours.
How Does Anesthesia Work?
To better understand how the different types of anesthesia work,
it may help to learn a little about the
nervous system
. Think of the brain as a central computer that controls all the
body's functions and the nervous system as a network that
relays messages back and forth from the brain to different
parts of the body. It does this via the
spinal cord
, which runs from the brain down through the back and contains
threadlike nerves that branch out to every organ and body part.
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. Here's how the ASA puts it into
perspective:
- With local anesthesia, the phone (the small part of the body
being numbed) is "off the hook" and, therefore,
can't receive calls (pain signals) from the switchboard (the
brain) or the phone cables (the nerves).
- With regional anesthesia, the phone cable (the nerves) broke,
causing all of the area's phones (entire area of the body
being numbed) to be out of service.
- With general anesthesia, the switchboard operator (the brain)
is on a break and, therefore, can't connect incoming calls
(pain signals).
Will My Child Get a Needle?
Often, anesthesiologists may give children a sedative to help
them feel sleepy or relaxed before a procedure or surgery. Then,
kids who are getting general anesthesia may be given medication
through a special breathing mask first and then be given an IV
after they're asleep. Why? Because many kids are afraid of
needles and young children may have a hard time staying still and
calm.
Thus, needles - typically one of the most frightening aspects of
surgery for kids - often can be avoided while the child is awake.
Many kids just need to breathe themselves to sleep, which may help
ease some anxiety about needles and the overall procedure or
surgery.
What Type of Anesthesia Will My Child Get?
The type and amount of anesthesia given will be specifically
tailored to your child's needs and will depend on various
factors, including:
- the type of surgery
- the location of the surgery
- how long the surgery may take
- your child's current and previous medical condition
- any allergies your child may have
- previous reactions to anesthesia (in your child or family
members)
- medications your child is taking
- your child's age, height, and weight
In some cases, you may be able to request which type of
anesthesia your child gets. The anesthesiologist can discuss the
options available, but, ultimately, will make the decision based on
your child's individual needs and best interests.
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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