General Anaesthesia

What is general anaesthesia?

General anaesthesia (say: an-iss-THEES-ee-a) is a mix of medicines that helps your child fall into a deep sleep. This means your child will not feel pain or remember the operation. General anaesthesia may be used when your child has an operation, test or treatment.

This information will help you and your child prepare for general anaesthesia. Please read this information carefully and explain it to your child, using words he or she can understand. Knowing what to expect will help your child feel less nervous. You can also contact the pre-anaesthesia clinic to help you and your child prepare.

What to feed your child before general anaesthesia

Your child’s stomach must be empty before general anaesthesia. If your child has even a small amount of food or drink in the stomach, your child could vomit (throw up) during the anaesthesia and damage his or her lungs. An empty stomach lowers the chance that your child will vomit.

Follow these instructions to make sure your child's stomach is empty. If you do not follow these instructions, your child's operation, test, or treatment will be delayed or cancelled.

  • At midnight before the anaesthesia, your child must stop eating solid food, gum, candy, milk or orange juice. Your child can still drink clear liquids up until three hours before the anaesthesia. Clear liquids means liquids you can see through like a window. Clear liquids include water, ginger ale and clear apple juice.
  • Three hours before the anaesthesia, your child must stop drinking clear liquids. Your child should not take anything by mouth until after he or she wakes up.
  • If your child needs to take prescription medicine, talk to your child's doctor before giving the medicine.

Your child is having general anaesthesia at this time: ________________________

Your child must stop drinking clear liquids at this time: ___________________

For babies

If your baby is breastfeeding, stop breastfeeding your baby 4 hours before the anaesthesia, at this time: ___________

If your baby drinks formula, stop giving formula 6 hours before the anaesthesia, at this time: _____________

Summary: Eating and drinking before general anaesthesia

Time

What your child can eat and drink

Midnight before the anaesthesia

Stop giving your child solid food, including gum, candy and orange juice. Your child must not eat anything until they wake up from the anaesthetic.

Your child may drink clear liquids, including clear apple juice, water and ginger ale. If your child only drinks water, you may give them Pedialyte.

6 hours before the anaesthesia

Stop giving your baby formula.

4 hours before the anaesthesia

Stop giving your baby breast milk.

3 hours before the anaesthesia

Stop giving your child clear liquids. Your child must not drink anything until they wake up from the anaesthetic.

If your child takes prescription medicine, ask your child's doctor when and how to give the medicine.

Assessing your child before general anaesthesia

Before your child's general anaesthesia, a nurse will call you to ask about your child's health. You may be asked to bring your child to the Pre-Anaesthesia Assessment Clinic. At this clinic, you and your child will talk with a nurse or an anaesthesiologist about the general anaesthesia. To reduce the risk of the procedure, the anesthesiologist needs to know about any medical conditions or problems your child has. You and your child will also talk with a nurse in the clinic about the care your child will need in the hospital before and after the operation.

Please bring a list of your child's medicines to the clinic.

Your child may need tests before general anaesthesia

The anaesthesiologist or your child's physician may decide that your child needs to have some lab tests before the general anaesthesia. This will depend on your child's medical history and why your child is having the general anaesthesia.

All girls aged 12 and over will have a urine test before receiving general anaesthesia.

If your child is sick before the operation, test, or treatment

Your child needs to be as healthy as possible before having a general anaesthesia.

If your child is sick at any time in the week before the operation, test, or treatment, call your child's doctor at the hospital right away. Call if your child has any of the following:

  • wheezing
  • cough
  • fever
  • runny nose
  • vomiting
  • generally feeling unwell

How general anaesthesia is given

Your child is given general anaesthesia either through a face mask or through a small tube in a vein called an intravenous line (IV).

If your child is very nervous, he or she may be given some medicine before the general anaesthesia. This will help calm your child so he or she can be less anxious about getting the general anaesthesia.

Who gives the general anaesthesia

The doctor who will give your child the general anaesthesia is called an anesthesiologist. An anesthesiologist is a doctor who helps with surgery and other painful or anxiety-provoking procedures by giving sedatives, painkillers, and anaesthetic drugs so that your child will sleep and will not be aware of anything during the procedure.

The anesthesiologist will care for your child and help your child cope with the effects of the general anaesthesia. During your child's operation, test, or treatment, the anaesthesiologist will be checking your child's breathing, heartbeat, temperature, and blood pressure. After the procedure, the anesthesiologist makes sure your child is comfortable and recovering well.

Your child may have side effects from the general anaesthesia

After general anaesthesia, your child may have minor side effects (problems), including:

  • fatigue (tiredness)
  • dizziness
  • irritability
  • sore throat
  • cough
  • nausea (feeling sick to the stomach)
  • vomiting (throwing up); if this happens, your child will get medicine to help him or her feel better

Serious side effects are rare

There is a very small chance that there will be a serious problem during or after your child's general anaesthesia. These problems are rare but may include:

  • an allergic reaction to a drug
  • brain injury
  • cardiac arrest, which means the heart stops beating; this can cause death

The anaesthesiologist will watch your child very closely during the operation, test, or treatment. He or she is trained to deal with these problems if they happen.

If your child has a serious problem, he or she may need to stay in the hospital for a longer time.

After the operation, test, or treatment

Your child will go to the Post-Anaesthetic Care Unit (PACU) or recovery room. Specially trained nurses will regularly check your child's breathing, heartbeat, temperature, and blood pressure. Your child will wake up soon after the operation, test, or treatment. You can be with your child as soon as he or she wakes up.

If your child has pain

Before your child wakes up from the general anaesthesia, he or she will get medicine for pain.

Managing your child's pain is important to help your child get better after the operation, test, or treatment. If you think your child is in pain, talk to your child's nurse or doctor so that they can help.

If you have any questions

On the day of your child's operation, test, or treatment, the anaesthesiologist will meet with you to talk about any questions and concerns you may have. If you have questions before then, call the anaesthesia department.

The team will work with you to make this the best possible experience for you and your child. Please call if you have any questions or concerns.

Key points

  • Your child's stomach must be empty during and after general anaesthesia. If your child's stomach is not empty, your child could vomit and damage his or her lungs. If you do not follow these instructions, your child's operation, test, or treatment will be delayed or cancelled.
  • Starting at midnight before your child's operation, test, or treatment, your child must not eat or drink any solid food, gum, candy, milk or orange juice. Your child must only have clear liquids such as water, ginger ale or clear apple juice until 3 hours before the anaesthesia.
  • Three hours before the operation, test or treatment, stop giving your child anything to drink.
  • There is a small chance your child may have serious side effects from the general anaesthesia. The anaesthesiologist will watch your child carefully to deal with these problems if they happen.

Silvana Oppedisano, RN, MN

James Robertson, MD, FRCPC

Nancy Rudyk, RN, BScN

11/17/2009

At SickKids:

If you have questions or concerns before your child's anaesthesia, call the Pre-Anaesthesia Clinic at 416-813-7654, ext. 3058. You can make an appointment or speak with an anaesthesiologist.

SickKids offers a Pre-Admission Program for children between the ages of 3 and 12 to help them get ready for an operation at the hospital. Your child can play with stethoscopes, hospital gowns, masks, and hats. To register your child for the Pre-Admission Program, please call 416-813-5819.

You can also take a virtual tour of the operating room at: http://www.sickkids.ca/ProgramsandServices/Pre-Admission-Program/virtual-OR-tour/index.html





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