Parents’ questions about children’s anaesthesia

Usually because the procedure needs a child to keep completely still, or would be too distressing awake. healthdirect explains that a general anaesthetic means your child won’t move and their muscles relax, so the procedure can be done properly. It also notes that sedation (a syrup or nose spray) may suit some scans, and a local anaesthetic some smaller procedures, depending on how mature and calm your child is. Ask whether any of these is an option.

This worry is common, and there is reassuring Australian-led research on it. The GAS trial, run from the Murdoch Children’s Research Institute in Melbourne across 28 hospitals in seven countries, compared 722 babies having hernia repairs: about half had a general anaesthetic of just under an hour and half stayed awake with a local or regional anaesthetic. At five years of age there was no difference in IQ, behaviour, memory or attention between the groups.

The trial looked at one anaesthetic of moderate length in infancy. If your child needs a long operation or many anaesthetics, ask the anaesthetist what is known for their situation.

healthdirect groups the risks into minor effects, such as nausea and vomiting, sore throat, behaviour changes, damage to teeth, shivering and allergic reactions, and serious complications, including breathing problems, a slow or irregular heartbeat, nerve injury, a life-threatening allergic reaction, cardiac arrest and death. It does not give rates. The anaesthetist can tell you which risks apply to your child and whether their risk is higher or lower than usual. See questions to ask the anaesthetist.

ANZCA says that to a child a general anaesthetic feels like a deep sleep. Some children remember the start, such as the mask or the drip. Children who wake up confused and upset usually do not remember that part, according to The Royal Children’s Hospital.

Not right up to it. ANZCA’s fasting guideline allows breast milk until 3 hours before the anaesthetic, for babies and for older children, and encourages clear fluids until 1 hour before. Your hospital may use different times. See fasting for babies and children.

Phone the hospital before you leave home and let the anaesthetist decide. ANZCA lists a cough, cold or fever among the things anaesthetists ask about to reduce the risk of complications. One Victorian children’s hospital says a child with a cold who otherwise feels well may still go ahead, while a fever or breathing difficulty may mean waiting. See coughs, colds and fevers for what to have ready when you call.

Possibly. ANZCA’s position on consent says the age at which a young person can consent independently depends on the treatment and the local law, and on whether they understand its nature, purpose and possible consequences. Otherwise a parent or legal guardian consents, and must act in the young person’s best interests.

Often, yes. ANZCA’s guideline on children’s anaesthesia says induction areas should allow a parent or carer to attend. Hospitals have exceptions: at The Royal Children’s Hospital, for example, babies under six months, emergencies and most night and weekend cases. Ask beforehand. See going to sleep.

ANZCA and the Australian Society of Anaesthetists both describe twitching, eye-rolling, snoring, noisy breathing and going limp as normal while a child falls asleep under anaesthetic. It looks alarming but is expected. See going to sleep.

Many children go home the same day. ANZCA’s guideline says well children with few other health problems would normally be suitable for day procedures, while some, including babies born early who have not reached 54 weeks postmenstrual age, should stay. If your child does stay, the guideline says a parent or carer should be able to stay with them.

It depends on the procedure. After general day surgery, The Royal Children’s Hospital says the surgeon will recommend when to return; after a tonsil operation, many children need two weeks at home. Ask before you leave hospital.

Behaviour changes such as anxiety, night-time crying, bed-wetting and tantrums are listed by healthdirect among the minor effects after a child’s anaesthetic. Keep to familiar routines and offer extra comfort. If changes last or worry you, see your GP. See waking up.

The guide is published by Dr Walid Aly, Specialist Anaesthetist, and written for him by Altitude Creative from Australian sources, with clinical review recorded on each page. It is general information. Your child’s anaesthetist is whoever is named by the hospital for your child’s procedure. See about Dr Walid Aly.

The Australian Society of Anaesthetists publishes its pamphlet on anaesthesia for children in English, Arabic, Simplified Chinese, Punjabi and Vietnamese. Some of its fasting times are older than ANZCA’s current guideline, so use the times your hospital gives you.