Millions of children have surgery every year - for everything from tonsil removal to correction of a heart defect - and understandably parents are often anxious about their child's safety and comfort. The American Society of Anesthesiologists (ASA) wants parents to know that anesthesia is extremely safe and effective at managing pain and discomfort surgery or a procedure may cause.
"Particularly in infants and toddlers, surgery is only recommended when it is necessary for the child's health, so parents should not avoid an important procedure out of fear," said Randall Flick, M.D., chair of the ASA's Committee on Pediatric Anesthesia, associate professor of pediatrics and anesthesia, Mayo Clinic, Rochester, Minn. "Physician anesthesiologists have received years of special training to help ensure safe, high-quality care and can set parents' minds at ease."
Communication helps to ensure a safe, comfortable easier experience. The ASA recommends parents ask these seven questions when talking to the child's physician anesthesiologist prior to any procedure:
How can I ensure my child has a successful surgery? One of the most important things you can do is to share your child's detailed health history with the physician anesthesiologist before the procedure. For example, be sure to note if your child has allergies or asthma. It's also vital to let the physician anesthesiologist know if your child has had a reaction to anesthesia previously.
If my child is taking medications, should they be stopped before the surgery? Provide the physician anesthesiologist a detailed list of all of the medications your child is taking, including pain medication and vitamins. Whether your child should stop taking them and when they can be resumed will depend on a number of factors, including how vital the medication is to your child's health and the type of surgery and anesthesia your child is having.
Should my child stop eating or drinking before surgery? In general, children (as well as adults) should stop eating solid foods six to eight hours before the surgery. Parents should encourage the child to sip clear liquids such as water, hydration drinks (Pedialyte) and apple juice up to two hours before the procedure. Breast milk is fine up to four hours before surgery.
How can I help my child prepare for surgery? Be reassuring and confident, letting your child know that the surgery is important to correct a problem or help him or her feel better. Explain that the doctor will provide medicine so that the surgery won't hurt, and in fact, your child won't even remember it. Note that nurses and doctors will be there to provide care every step of the way, and you will be waiting close by to see your child when the surgery is over.
Is anesthesia safe for my child? Parents should be comforted to know that anesthesia is extremely safe. As with adults, the risk may increase if the child has complex problems, or the surgery is urgent, but even in those cases, the risks are very low. There have been several small studies looking at whether anesthesia given to infants and toddlers can affect learning but the results have been conflicting. Researchers are continuing to study this issue. Further, surgery is typically only recommended for infants and toddlers when necessary, and should not factor into the decision-making process when surgery is vital for the child's health.
Will my child be in pain after surgery? Your child's physician anesthesiologist will prescribe medication to manage pain, which might include medication to be taken by mouth or received through a pump or injection. If your child feels nauseated or vomits after surgery, the physician anesthesiologist can help. The goal is to help your child be as comfortable as possible while recovering from surgery. Opioids such as oxycodone may be prescribed for pain relief. These medications are safe when taken under the supervision of the physician anesthesiologist. Talk to your doctor if you have concerns. The medications should be properly disposed of when they are no longer needed to control the pain.
What type of anesthesia will my child have? There are several types of anesthesia, including medication provided through an intravenous (IV) line or through a mask that your child will inhale. The physician anesthesiologist will recommend the best type of anesthesia for your child, which will depend on your child's health and the type of surgery.
You should feel free to ask your child's physician anesthesiologist all of your questions before surgery, as well as the day of the procedure. As a resource, ASA created a checklist for caregivers that can be downloaded and taken to the hospital the day of your child's surgery.