Pediatric Anesthesia

Before Anesthesia

We look forward to caring for your child. If you have any questions or concerns, please discuss them with your anesthesiologist.

Giving Your Child the Best Care

• Give us a complete medical history, including any kind of medical condition or problem your child may have.
• Tell us about your child’s past experience with anesthesia.
• Let us know if anyone on either side of the family has had difficulty with or an allergic reaction to anesthesia, or has a neuromuscular disease like muscular dystrophy.
• Tell us what medications or supplements your child is taking.

Evaluation Before Anesthesia

• A nurse or nurse practitioner will call most parents before the procedure to review your child’s record. The anesthesiologist will meet you and your child on the day of anesthesia.
• If your child has a lot of medical problems, you may be asked to come in to meet an anesthesiologist before the day of the procedure.
• If your child is already in the hospital, a member of the anesthesia team will see your child ahead of time.

Please tell us your concerns and ask questions, even simple ones. You know your child best. Tell us how you think your child will cope and what we can do to help. If you or your child are very anxious, we can arrange for a child life specialist to work with your child to help them feel as safe and comfortable as possible.

Telling Your Child About the Procedure

Before the scheduled day of anesthesia, make sure your child’s doctor has explained to you why the procedure is needed and how it is done. It may help you to re-explain things to your child and answer any questions.

• If your child is under 6 years of age, you should explain the plan one to two days before it happens.
• If your child is over 6 years of age, it is best to explain and prepare your child three to four days before the procedure.

Preparing for Your Child's Procedure

Your surgeon, doctor or radiology office will tell you what time to arrive. They will also give you instructions about what time your child needs to stop eating and drinking. The general rule is no food or drink after midnight before surgery, EXCEPT:

• Clear liquids (water, juice without pulp, Pedialyte): stop two hours before arrival
• Breast milk: stop four hours before arrival
• Infant formula: stop six hours before arrival

In the days before the surgery: If your child develops a cough, cold, fever or vomiting, or was around anyone with a communicable disease, like chicken pox, contact us right away — you should call the office that scheduled your surgery or test.

During Anesthesia

How Anesthesia is Given

This information may be helpful when talking to your child about what to expect.

• If your child is very anxious, we may suggest they drink some medicine first to calm them.
• Most young children will go to sleep breathing a medication through a mask. An IV is placed after they fall asleep. However, sometimes it is safer to start the IV first.
• Older children usually have the IV placed first, and will go to sleep by medication given through the IV. A numbing cream can be used on the skin to make the placement/ poke hurt less.
• You can stay with your child as we prepare for anesthesia. This will help your child feel more secure and calm.
• Whenever possible, you can stay with your child until he/she falls asleep. Some exceptions are emergency situations or very young infants.
• Some parents get upset watching their child fall asleep under anesthesia. We will help you through the process if you stay. Do not feel pressured to stay in the operating room.
• While children are going to sleep with a mask, it is helpful to talk in a calm and comforting way about something that interests your child. Children can sense parents’ anxiety, so we want you to be as relaxed as possible.
• If your child becomes upset while breathing in the mask, try not to say “it’s OK.” It is more helpful for us to try to distract your child.

Beginning Anesthesia

When beginning to fall asleep, your child may:

• Snore or make funny noises
• Roll eyes upward
• Seem restless and move around

All of these things are very normal and expected, and last about 30-60 seconds. It may seem like children are awake, but they will not remember anything. Once your child has fallen asleep, we will ask you to give him/her a kiss, then return to the waiting room so we can continue to safely watch your child.

Watching Your Child

Anesthesia is very safe. Our newer medications and monitors help with safety. We watch your child very carefully in the operating room.

• A band-aid like device is placed on the finger or toe to measure the amount of oxygen in the blood.
• A cuff is placed on the arm or leg to measure blood pressure.
• We measure the amount of oxygen and anesthesia breathed in, as well as the carbon dioxide breathed out. This helps us to know how well the medications are working.

Recovering from Anesthesia

When your child wakes up from anesthesia, you will see him/her in the recovery area:

• Your child may be confused, restless and not recognize you. This lasts from 5-15 minutes and usually goes away on its own.
• We will watch your child closely for discomfort or pain and give pain medications if needed.
• Your child may feel nauseated or vomit. We give medications to help prevent these side effects in children likely to get them. If your child does vomit, we will give medication to try to help.

Important Phone Numbers and Pediatric Procedural Areas

• Center for Perioperative Care: Pediatrics 617-726-8598
• Pediatric Endoscopy, Blake 4 857-238-7350
• Pediatric Radiology, Ellison 2 617-724-4207
• Francis H. Burr Proton Therapy Center, Yawkey Basement 617-726-0923
• John Hancock Child Life and Wellness Services 617-724-1211
• Pediatric Anesthesia 617-724-2250

Rev. 5/2012. This document is intended to provide health related information so that you may be better informed. It is not a substitute for a doctor's medical advice and should not be relied upon for treatment for specific medical conditions.