The two ways an anaesthetic starts
Every general anaesthetic for a child starts in one of two ways. The anaesthetist chooses, often with you and your child, based on age, health, the procedure and what your child can manage.
| Compared | Breathing gas through a mask | Medicine through a drip |
|---|---|---|
| What happens | A mask rests over the nose and mouth and your child breathes in the anaesthetic gas. | A thin plastic tube (a cannula, or drip) goes into a vein, usually in the hand or arm, and the medicine is given through it. |
| Who usually has it | More common for babies and younger children, according to healthdirect. | healthdirect says most older children go to sleep this way. |
| How long it takes | Usually only about a minute (healthdirect). | About 30 seconds (healthdirect). ANZCA says it is usually faster than gas. |
| What your child notices | The mask on their face and a smell, which The Royal Children's Hospital says is not particularly unpleasant with newer gases. They may be a bit restless as the gas starts to work. | A sharp scratch as the drip goes in, which numbing cream can reduce. Then sleep comes quickly. |
| When it may be preferred | Children who are frightened of needles, and many younger children. | ANZCA says that in some situations, such as for older children or in an emergency, starting through a drip is preferred. |
Even when your child goes to sleep with a mask, the anaesthetist may still need a drip during the procedure. Ask whether one is planned, and where it will go, so your child is not surprised to wake up with it.
Can my child have a say?
Often, yes. healthdirect notes that some children prefer to go to sleep breathing anaesthetic gas through a face mask; others would rather have a drip. A child who hates needles may cope well with a mask; a child who hates things on their face may prefer the drip and numbing cream.
Talk it over at home first, then tell the anaesthetist what your child would choose and why. In an emergency, or for some medical reasons, the anaesthetist may need to use one particular way, and will explain why.
Practising at home
- For a mask: let your child hold a cup or a toy mask over a teddy’s face, then their own, while they take slow breaths. Practising a few times takes the surprise out of it.
- For a drip: explain the scratch honestly, and practise a distraction to use at that moment. The Royal Children’s Hospital suggests bubbles or a windmill, singing or light-up toys for toddlers; big belly breaths, counting games or a search-and-find book for older children; and music through headphones or a favourite show for teenagers.
Numbing cream and calming medicine
Numbing cream is a local anaesthetic cream put on the skin where a drip may go. The Royal Children’s Hospital says it can take 45 to 90 minutes to work, and that ice or a cooling device can be used instead. Ask when it will go on, so it has time to work, and try to keep small fingers off the dressing in the meantime.
Calming medicine (a premedication, or premed) may be offered if your child is very anxious. ANZCA describes it as sedation to help with anxiety. The Royal Children’s Hospital says a premed can be given 15 to 60 minutes before surgery, usually mixed with a small amount of syrup, cordial or paracetamol mixture. Once it has been given, keep your child on the bed or on your lap: they may become drowsy and unsteady.
Being in the room
ANZCA’s guideline on anaesthesia care for children (PG29(A), section 9.1.1) says induction areas should be child-friendly and allow a parent or carer to be there. How that works varies between hospitals:
| Source | What it says |
|---|---|
| The Royal Children's Hospital, Melbourne | One parent may be allowed to come in. Usually not for babies under six months, emergencies or most night and weekend cases. |
| Sydney Children's Hospitals Network | Children over six months may be able to have a parent or carer in the anaesthetic room. Talk to the anaesthetist about whether this is possible. |
The Australian Society of Anaesthetists adds that the decision depends on the anaesthetic and theatre staff on the day. So ask ahead, and have a plan for either answer.
Teenagers may feel differently from younger children. The Royal Children’s Hospital suggests letting adolescents choose whether a parent is there and whether to hold hands.
What helps in the room
- One calm adult. The Royal Children’s Hospital advises parents who are very nervous or upset not to come into the anaesthetic room. Another adult your child trusts can go instead. Choosing that is a sensible decision, not a failure.
- Touch and a calm voice. A hand to hold, or a small child on your lap. The Royal Children’s Hospital recommends a calm voice and distraction.
- The distraction you practised. A song, a story, a game, slow breaths.
- Following the team’s lead. They will show you where to sit and when it is time to go.
What you may see as your child falls asleep
This is the moment parents find hardest, and it helps to know in advance that none of it means something is wrong:
- ANZCA says twitching movements, eye-rolling, snoring and other changes in breathing are normal as the anaesthetic takes effect.
- The Australian Society of Anaesthetists says children may wiggle, roll their eyes, breathe noisily or even go limp, and that this is normal.
- The Royal Children’s Hospital says that with medicine through a drip, a child may become unconscious quickly and look pale and floppy.
The Royal Children’s Hospital asks parents to agree to leave when they are not feeling well, when staff ask, and once the child is asleep. Give your child a kiss and leave with the staff member, who will show you where to wait. Feeling shaky or teary afterwards is common. ANZCA notes that staff will make sure they have your phone number so they can call you to recovery.
After you leave
ANZCA explains that when the procedure is finished, the anaesthetist stops the anaesthetic medicines, starts the wake-up process and then takes your child to the recovery area, where a trained recovery nurse takes over. Waking up explains what comes next, and on the day covers the rest of the day around this part.
Common questions
Will my child remember going to sleep?
Often not. The Royal Children’s Hospital says a calming premedication often affects memory after the event, so children rarely remember going off to sleep. Without a premed, some children remember the mask or the drip. ANZCA describes the anaesthetic itself as feeling like a deep sleep.
Does the anaesthetic gas smell?
It has a smell, but The Royal Children’s Hospital says the newer gases do not have a particularly unpleasant one. Children sometimes notice it more than they mind it. Telling your child beforehand that the air in the mask smells a bit different can help.
Can my child take a toy or tablet into the room?
Usually something can go in with them. ANZCA suggests bringing toys or devices that help your child feel more comfortable. Ask the nurse what can go into the anaesthetic room, and put your child’s name on it.
My child panicked last time. What can be done differently?
Tell the anaesthetist exactly what happened and at which step: the mask, the needle, being held, or leaving you. They can consider calming medicine beforehand, numbing cream and a drip instead of a mask, or the reverse. The plan should be built around what your child finds hardest.
Sources
- healthdirect Australia. General anaesthetic (child). Last reviewed Jan 2026.
- ANZCA. Anaesthesia and children (patient information). Page modified 26 Oct 2026.
- The Royal Children's Hospital Melbourne. Anaesthesia and Pain Management: information about your child's anaesthetic. Accessed 2 Nov 2026.
- The Royal Children's Hospital Melbourne. Preparing your child for surgery: general anaesthesia (Kids Health Info). Updated Jul 2025.
- The Royal Children's Hospital Melbourne. Reducing your child's discomfort during procedures (Kids Health Info). Updated Jul 2025.
- Australian Society of Anaesthetists. Anaesthesia for children (pamphlets in English, Arabic, Chinese, Punjabi and Vietnamese). Pamphlet last reviewed 12 Mar 2024; page modified 22 May 2026.
- Sydney Children's Hospitals Network. General anaesthetic and surgery factsheet. Accessed 3 Nov 2026.
- ANZCA. PG29(A) Guideline for the provision of anaesthesia care to children (sections 9.1.1, 9.4.3, 10.1.4, 10.1.6, 10.1.8). November 2020; links reviewed March 2025.
- Written by
- Altitude Creative, health content team, on behalf of Dr Walid Aly
- Clinical reviewer
- In progress
- Review date
- Clinical review in progress
- Next review due
- Set at clinical review
How this guide is written, sourced, reviewed and corrected: editorial policy.
In an emergency, call 000. This information is general and does not replace advice from your treating practitioner. Your child's anaesthetist, surgeon, dentist or hospital knows your child, and their instructions come first.