PATIENT INFORMATION
Information for Parents and Children
Practical guidance to help you prepare your child for an anaesthetic, understand what happens on the day, and know what to expect afterwards.
Every child is different. Your anaesthesiologist will consider your child’s age, health, procedure and individual needs when planning their anaesthetic and pain relief.
Prepare gently
Use simple, honest words your child can understand.
Follow fasting instructions
Eating and drinking rules are important for your child’s safety.
Bring comfort items
A favourite toy, blanket, dummy, book or device can help your child feel calmer.
PREPARING
Preparing your child
Children cope best when they are prepared in a calm, simple and age-appropriate way. Try to use words your child can understand, and be honest without giving too much detail.
You do not need to explain every medical step. It is often enough to say that the doctors and nurses will help them have a special sleep so that they do not feel the procedure.
Helpful ways to prepare
- Use simple, reassuring language.
- Tell your child they will be looked after the whole time.
- Let them ask questions and answer honestly.
- Avoid frightening words such as “cut”, “needle” or “pain” where possible.
- Keep your own tone calm and confident.
- Tell the team if your child has had a difficult previous medical experience.
FASTING
Fasting instructions for children
Light meal, cow’s milk or formula
Your child may usually have a light meal, cow’s milk or formula milk up to six hours before surgery.
Breast milk
Babies may usually be breastfed up to four hours before surgery.
Clear fluids
Children may usually drink clear liquids (max 3ml/kg per hour) up to two hours before surgery. Examples include water, apple juice or Oros.
Avoid
Avoid fizzy drinks, dairy-based drinks and drinks with particles, such as orange juice. If you are unsure, check with your healthcare team before giving anything.
Why fasting matters
Food or liquid in your child’s stomach could come up into the throat and damage the lungs during the anaesthetic. To make fasting easier, try not to eat or drink in front of your child while they are fasting.
Always follow the specific fasting instructions provided by your hospital, surgeon or anaesthesiologist.
PACKING
What to bring
Familiar items can make the hospital environment feel less strange for your child. Bring something comforting for waiting, going to sleep and waking up in recovery.
Useful items
- A favourite toy, blanket or comfort item
- A dummy or bottle if your child uses one
- A book, game, movie or tablet for distraction
- Any medication your child has been asked to bring
- Glasses, hearing aids or other aids if needed
- Comfortable clothing for going home
Helping an anxious child
It is normal for children to feel nervous before a procedure. Your calm reassurance can make a big difference.
Some children may benefit from medicine before going to theatre to make them less anxious. This can be discussed with your anaesthesiologist.
- Tell your child what will happen in simple steps.
- Let them choose a comfort item to bring.
- Use distraction such as a story, game or movie.
- Tell the team about sensory sensitivities, anxiety, communication needs or previous difficult experiences.
- Remember that there is no pressure on you to go into theatre if you do not feel able to.
ON THE DAY
What happens on the day?
Before theatre
Your anaesthesiologist will visit you and your child, review medical information and answer questions.
Going to theatre
You may be able to go into theatre with your child, depending on the situation and hospital policy.
Going to sleep
The anaesthetic may be given through a drip into a vein or as gas breathed through a mask.
During the operation
The anaesthesiologist stays with your child, monitoring them and giving fluids, medication and pain relief.
Recovery
Your child is taken to recovery and you will usually be called in when they are awake enough.
How children go to sleep
If anaesthetic gas is used, a mask fits over your child’s mouth and nose. The gas can smell unusual, but it is not painful. Some children may wriggle or make funny movements as they go to sleep; this is normal and the team will talk you through it.
If an injected anaesthetic is used, local anaesthetic numbing cream may be placed on your child’s hands before going to theatre.
AFTERWARDS
Recovery and going home
After the procedure, your child will be looked after in the Recovery Room by trained recovery nurses. When your child is awake enough, you will usually be called into recovery to be with them.
Some children wake calmly, while others may be tearful, confused or unsettled. They may not recognise you at first because of the unfamiliar environment and the effects of the medication. This is common and usually passes.
What you may notice afterwards
- Sleepiness or tiredness
- Nausea or vomiting
- Sore throat
- Headache
- Feeling “jetlagged” or out of sorts
- Clinginess or disturbed sleep for a couple of days
At home
Follow the discharge instructions given by the hospital. Offer reassurance, keep the day calm, and give pain medication as advised. If you are worried about your child after going home, contact the hospital, surgeon or anaesthesiology practice.
FAQ
FAQ for parents
What should I tell the anaesthesiologist before the operation?
Please tell the anaesthesiologist about any medical problems, allergies, previous operations or previous anaesthetics your child has had. Also mention any recent illnesses within the last 1-2 weeks, especially febrile or respiratory illnesses.
The anaesthesiologist will discuss any concerns you have and talk through pain-relief options where needed.
Could my child’s procedure be delayed?
Occasionally a procedure may need to be delayed to make it safer for your child. This may happen, for example, if your child has a chest infection or has eaten too recently.
Can I go into theatre with my child?
In many cases, a parent or guardian may be able to go into theatre while the anaesthetic is started. This depends on the hospital, procedure and situation.
There is no pressure to go into theatre if you do not feel able to. The anaesthetic team is there to care for your child.
How is a child’s general anaesthetic given?
A general anaesthetic may be given either by medication injected into a vein or as anaesthetic gas to breathe through a mask or breathing tube. The anaesthesiologist will discuss the best option with you.
Please let the team know if your child has had procedures before and has a preference.
Will anaesthesia damage my child’s brain?
Parents sometimes worry about whether anaesthesia could affect a child’s developing brain. The PACSA position statement explains that animal studies raised concern, but those studies used doses and exposure times that were not comparable with routine clinical anaesthesia in children.
Human studies have shown associations in some situations, particularly where children have multiple procedures, but they have not shown that anaesthesia causes later learning or emotional problems. Early results from newer studies are reassuring.
There is no recommendation to delay necessary surgery unnecessarily, and surgery without anaesthesia and pain relief would be unethical. A well-conducted anaesthetic with appropriate monitoring by a trained anaesthetist is the best way to reduce risk.
What is a caudal block?
A caudal block is a pain-relieving injection of local anaesthetic at the base of the back, performed while your child is under general anaesthetic. It numbs the nerves going to the area of the operation and can provide pain relief for surgery below the belly button, such as hernia repair, circumcision or operations on the legs.
It usually provides pain relief for about 6–8 hours, although this varies.
What side effects can happen after a caudal block?
- Weak or heavy legs while the local anaesthetic is working
- Inadequate pain relief if the block does not work fully
- Temporary difficulty passing urine
- Very serious but rare complications such as nerve damage, infection or bleeding
If your child’s legs are weak or heavy, supervise them carefully if they walk or crawl, and be careful with hot baths because they may not sense temperature normally while the block is working.
What are the common side effects of general anaesthesia in children?
The most common side effects are usually mild, resolve quickly and can be treated. They include nausea, vomiting, sore throat and headache. Your child may also feel “jetlagged” or generally out of sorts for a while.
More serious problems, such as allergic reactions to medication, are rare and monitored for.
NEED HELP?
Still have questions?
Your anaesthesiologist will discuss your child’s anaesthetic plan, pain relief and any concerns you may have before the procedure.
