ANAESTHESIA AND ANAESTHETISTS

What is anaesthesia?

The word anaesthesia means loss of sensation.

A general anaesthetic ensures that your child is unconscious and free of pain during a test (investigation) or operation.

• General anaesthesia is a state of controlled unconsciousness and freedom from pain.
• Anaesthetics are the drugs (gases and injections) that are used to start and maintain anaesthesia.

The anaesthetists

Anaesthetists are specialist doctors who give the anaesthetic and look after the health of your child during surgery. They are also closely involved with your child’s pain relief after surgery. 

Choice

It may be possible for you and your child to choose how the anaesthetic and other medicines are given. Sometimes there are medical reasons why things have to be done in a certain way – these will be explained to you.

Nothing will happen unless you understand and agree with what has been planned.

Your wishes and those of your child are very important.

We want to work with you to provide the best possible care for your child and family. 

PREPARATION

There are many things that you can do to prepare your child for coming into hospital.

All children (except infants too young to understand) should be told:

• That they are going into hospital;
• That they will be having an operation or investigation;
• Some basic information about what will happen to them when they are in hospital.

Everything should be explained to your child in a way that he/she can understand. FV Hospital has staff who can give explanations and encourage discussion through play.

Timing

Children between 2 and 3 years of age should be told 2 – 3 days before and again on the day of admission.

Children between 4 and 7 years of age should be told 4 – 7 days before the day of admission.

Older children will usually be involved in making decisions about the operation or investigation and discussion can take place a few weeks before the day of admission. 

If you and your child would like to visit the ward and operating theatres before the day of admission, please just ask us. 

ON THE DAY OF ADMISSION

A pre-operative visit

You will either meet with your anaesthetist before admission or an anaesthetist will visit you on the ward before the procedure to discuss your child’s anaesthetic.

The anaesthetist needs to find out about your child’s general health, previous experiences of anaesthesia, any medicines your child is taking and any allergies he or she might have.

This is a good time to talk about any previous experiences your child has had with injections or hospitals, or any particular concerns you have about this.

You may find it helpful to make a list of questions you want to ask.

Questions you may like to ask the anaesthetist

• Who will give my child’s anaesthetic?
• What type of anaesthetic do you recommend?
• Have you often used this type of anaesthetic?
• What are the risks of this type of anaesthetic?
• Does my child have any special risks?
• How will my child feel afterwards?

For practical reasons, the anaesthetist who you meet pre-admission or who comes to see you on the ward may not always be the same one who gives your child’s anaesthetic, but the information you give them will be passed on.

Delaying the operation or investigation

Occasionally the anaesthetist may learn something about your child that means it would be safer not to do the procedure on that day.

This could happen if your child has a bad cold, fever, has a rash or has eaten food too recently.

Nothing to eat and drink – fasting (“Nil by mouth”)

The hospital will give you clear instructions about fasting. It is important for your child to follow these.

If there is food or liquid in your child’s stomach during the anaesthetic, it could come up into the back of the throat and damage his or her lungs.

Unless your surgeon or anaesthetist tells you otherwise, these are the latest times that you should give your child anything to eat or drink:

• 6 hours before your child can have a light meal, a glass of milk or a carbonated drink. Bottle fed babies can have formula feed.
• 4 hours before babies can have breast milk.
• 2 hours before your child can have a carbonated drink without residue, no milk, no fruit juice, no soup.

Premedication

Premedication (a ‘pre-med’) is the name for drugs which are given before some anaesthetics. Some pre-meds help your child to relax, and some are given for other reasons (see below).

Not every child needs a pre-med. Depending on the kind of surgery and your child’s condition, you will often be able to help decide, with the anaesthetist, whether your child needs a pre-med or not.

If your child does need a pre-med, this will usually be given as a liquid. Occasionally an injection is essential. Pre-meds are given some time before the anaesthetic.

They may make your child drowsier after the operation or investigation, and if you plan to take him or her home on the same day, this may be delayed.

The drugs used can be:

• Sedatives to ease your child’s anxiety
• Medicines to protect your child from side effects of the anaesthetic (for example, nausea)
• An extra dose of treatment for illnesses like asthma.

Going to “theatre”

Your child may be able to wear his or her own clothes to the operating theatre, but if not most hospitals provide gowns to wear.

Your child will be asked to remove the underwear.

Your child may travel to the anaesthetic room in a bed, on a trolley, walking or being carried.

Anaesthetic room – the room next to the operating theatre where anaesthetics are usually started.

Operating theatre – the room where surgery is performed. If your child is very small, or is having certain kinds of surgery, it may be safer to give the anaesthetic in the operating theatre rather than in the anaesthetic room.

Recovery room – a place near the operating theatre where children go after surgery until the effects of the anaesthetic drugs wear off.