Fasting guidelines<6 months
*Clear fluid is anything you can see through which isn’t cloudy! E.g. apple juice, water and lemonade (not coke or milk) |
How your child goes to sleepMost children go to sleep with gas delivered though a mask. Some children prefer a needle inserted after numbing cream is applied.
It really helps to tell your child about 'the mask to fall asleep' before they come for their procedure at any age. Even if they seem very upset at the time, it prepares them for what is about to happen and makes it easier for them on the day. If your child is anxious, they may benefit from a sedative before they come in to the operating room. Please let the nurse know when you arrive if you think this is needed. Most parents will be offered the opportunity to be with their child whilst they go to sleep. |
Waking up and going homeAs soon as your child wakes up, we will call you to be with them.
We usually offer them an icy pole when they wake up. If they are a small baby or infant you may breast feed or give them a bottle of milk in the recovery room. Once your child has had a drink and a snack and any pain is controlled, they can go home. They are often still a bit dizzy or wobbly even when they are ready to go home safely. It is not uncommon for them to vomit on the way home in the car, a combination of travel sickness and the anaesthetic. Bring a towel/ bucket just in case. Be wary of stopping off for food on the way home even if they're hungry as you may see it again in the car! 
| ||
I
What should I expect as they fall asleep?
If a child chooses to go to sleep with a mask, they will go through some brief stages of anaesthesia. Initially they will be reassured about the mask, and encouraged to keep it on their face. It smells nice at first as they put a flavour in the mask. As we introduce the sleeping gas it smells a bit like petrol fumes or nail polish remover, for example. After they have breathed the gas for about 30 seconds they will start to fall asleep. Often you will see their eyes roll a little bit or they start wiggling, this is just dreaming and although it looks a bit odd is nothing to be concerned about. If you are expecting this it usually doesn't alarm you.
Once they close their eyes we will ask you to leave. You may come back as they wake up.
Once they close their eyes we will ask you to leave. You may come back as they wake up.
What should I expect as they wake up?
Children of the ages between 2-5yrs often wake up confused and disorientated. This is common and is called emergence delirium.
I routinely give the children I care for medication at the end of their procedure to slow the wake up down. This allows them more time 'to sleep it off'. When they wake up, they are then more like their normal self. Don't worry if it takes a while for them to wake up, it is often better this way, rather than waking up fast and upset.
Children are usually a bit sad or confused when they wake up as they are in a strange place, and feel dizzy and uncomfortable. They are often unable to express how they feel and as a result they cry. Children often cry when they wake up even if it isn't sore. I always given pain medication to them before they wake up to try to ensure they are not in pain.
When children have dental surgery, they have a tube put in the nose when asleep. This tube comes out before they are awake so they don't know anything about it. You may see blood in the nostrils or they may have a nose bleed as a result of this tube.
Children often vomit after anaesthesia. They are not usually distressed by this as they often feel much better straight away. They may vomit if they are given too much fatty foods on an empty stomach, like ice cream. Simple non-fatty foods are best after anaesthesia like sandwiches/ rice or pasta. Infants and children are often so hungry when they wake they eat too much then vomit.
I routinely give the children I care for medication at the end of their procedure to slow the wake up down. This allows them more time 'to sleep it off'. When they wake up, they are then more like their normal self. Don't worry if it takes a while for them to wake up, it is often better this way, rather than waking up fast and upset.
Children are usually a bit sad or confused when they wake up as they are in a strange place, and feel dizzy and uncomfortable. They are often unable to express how they feel and as a result they cry. Children often cry when they wake up even if it isn't sore. I always given pain medication to them before they wake up to try to ensure they are not in pain.
When children have dental surgery, they have a tube put in the nose when asleep. This tube comes out before they are awake so they don't know anything about it. You may see blood in the nostrils or they may have a nose bleed as a result of this tube.
Children often vomit after anaesthesia. They are not usually distressed by this as they often feel much better straight away. They may vomit if they are given too much fatty foods on an empty stomach, like ice cream. Simple non-fatty foods are best after anaesthesia like sandwiches/ rice or pasta. Infants and children are often so hungry when they wake they eat too much then vomit.
What should I do if my child is really anxious about it?
It really helps to tell your child as much as you can about 'the mask to fall asleep' before they come for their procedure, at any age. Even if they seem very upset at the time, it prepares them for what is about to happen and makes it easier for them on the day.
They also have the time to think about questions they may have. There is good evidence that talking them through it before makes it much smoother and less stressful for them on the day.
It is best to try to be as factual as possible with your description of what will happen. The videos on the 'for children' section are approved educational videos to help you and your child prepare.
If your child is anxious, they may benefit from a sedative before they come in to the operating room. Please let the nurse know when you arrive if you think this is needed.
They also have the time to think about questions they may have. There is good evidence that talking them through it before makes it much smoother and less stressful for them on the day.
It is best to try to be as factual as possible with your description of what will happen. The videos on the 'for children' section are approved educational videos to help you and your child prepare.
If your child is anxious, they may benefit from a sedative before they come in to the operating room. Please let the nurse know when you arrive if you think this is needed.
What should I do if my child has a cold?
Please let me know if your child has had a cold (or yourself if you are the patient) within the last month. If the cold is severe, your child has a fever or they are unwell to the extent they are lethargic or off their food, they must be cancelled and delayed until they have been well for up to a month. Some children, for example those with recurrent tonsillitis, are unwell all the time. These children will be cancelled if they are actively unwell but may still go ahead if their cold is getting better and was not less than a month ago. Each patient is considered on an individual basis.
There is a risk of airway irritability, asthma like reactions and a worsening of their chest infection if they have an anaesthetic whilst unwell. This is why we rather delay the operation when we are concerned. Your surgeon will understand these risks and make arrangements for a later date.
There is a risk of airway irritability, asthma like reactions and a worsening of their chest infection if they have an anaesthetic whilst unwell. This is why we rather delay the operation when we are concerned. Your surgeon will understand these risks and make arrangements for a later date.
Are there any risks to the developing brain with anaesthesia?
The risks of anaesthesia causing developmental delay is extremely small. If your child needs an operation, the risk of not doing it far exceeds the risk of the anaesthetic.
See smarttots.org for more information.
See smarttots.org for more information.