Information for Parents

Dear Parents,

Your child is admitted for surgery; this is a significant event in both their life and yours. This event naturally causes concern, which stem from the love you have for your child and your desire to see them healthy and happy. Familiarity with the system responsible for the safety and security of your child in the perioperative period can help alleviate some of your worries as well as help you make important decisions for the procedure. This page will try to give answers to questions related to anesthesia, which can be a source of concern before an operation.

Role of the anesthesiologist
Sedation medications or anesthesia are administered under the supervision of an anesthesiologist and a nurse, both of whom are responsible for administering sedation medication or anesthesia (depending on the type of procedure), while taking the child's age, health and other vitals into consideration. Our staff's special skills include creating a relaxed atmosphere, attentive to each child's personal needs.

The anesthesiologist's main goal is to ensure safe conditions needed in order to perform the required operation. These conditions include deep sleep, dulling the pain sensation during the operation, and creating a state where the patient will not move. These conditions can be created using anesthetic drugs. Administering these drugs requires strict supervision of vital body systems, such as breathing, heart activity, blood pressure and body temperature. The anesthesiologist continuously supervises these important activities of the body and is specifically trained to deal with every abnormality. The anesthesiologist's also has sophisticated monitoring devices to keep track of the child's reaction to the sedation medication/anesthesia which will alert him in advance of any change taking place.

Introduction and Testing
Safe anesthetics require some preconditions. Prior to procedures under sedation or anesthesia, the family will usually meet with the anesthesiologist and receive an detailed explanation about the procedure. The meeting is held at the pediatric clinic on the first floor of the Mother and Child building. This meeting serves a dual purpose: familiarization and relaying information about your child's health, such as their general development, sensitivities to medications, allergies, unconventional reactions to anesthesia in the family or the child. Your child will undergo a brief physical exam to ensure that they're at their best and do not suffer from any illness unrelated to the operation which may require postponement of surgery.

Fasting
On the day of the test or treatment, the child will need to need to come while fasting. At the meeting you will receive instructions for fasting prior to surgery. Fasting is important as it prevents inhalation of stomach content into the lungs during anesthesia.

Falling asleep
The pre-surgery meeting serves an additional purpose which allows us to determine the extent of sedation needed before entering the operating room. The sedatives are usually given orally shortly before anesthesia. The medications may be applied in several ways, depending on the age, type of medication and the child's preference: aspiration (mask), IV (injection) or through the digestive system (drinking the medication, suppository).

When the anesthetic takes effect and the child no longer feels pain, additional measures are taken that will ensure the safety of the child, such as installing a line for intravenous fluids and maintaining the airway. At this point it is generally accepted to add a local anesthetic injection to the local area being operated on in order to avoid postoperative pain. When all of these measures and drugs have been administered, then the surgery can start. The anesthesiologist continues to give anesthetic drugs as required, carefully monitoring any changes and responding accordingly.

Waking up
After surgery the anesthesiologist stops giving the anesthetic drugs and the child wakes up. This step also requires special supervision as it varies among children. Sometimes revival can be immediate and stormy and sometimes slow and moderate; both need continued supervision. When the child is again able to control their own vital functions (such as normal breathing and normal muscle tension), they are then transferred to the recovery room to complete the follow-up. During this period, painkilling drugs or treatment are sometimes added due to vomiting.

How can you as parents help your child?
Our team of nurses, doctors and surgeons and anesthetists dotheir best to make the perioperative period as pleasant as possible. Of course, parents also play a very important role in creating a warm and loving atmosphere for your child. It is worthwhile to prepare children for surgery, based on their individual ability to comprehend the process.

1. Preparation - A large part of the concerns patients and their families have before surgery stems from fears of the unknown. Knowing what's going to happen can alleviate many of these concerns. To do this, you need to obtain all the information related to anesthesia from your doctor and share this information to your child in a way that corresponds with his age and ability. There are videos, illustrated books and computer games that can help in giving over this explanation. It is important to prepare the child for an unfamiliar environment and for the possibility of discomfort after surgery. Together with this, let your child know that he will be surrounded by a compassionate, capable and loving environment the whole time and that you will be close by.

2. Soothing Accompaniment - In our hospital, we allow parents to accompany their children into the operating room and to be by their sides after beginning anesthesia. Your facial expression is very important at this stage. Nothing calms a child more than a calm parent. Even if there is some trepidation, which is natural, try not to show it at this time so as not to burden him. It is important to keep in mind that sedation and anesthesia are important procedures when treating a child.

3. A Smile and A Song - Talk with your child about the new environment they are in, tell a favorite story or a familiar poem. A favorite toy or book can help a lot, and there is no substitute for your warm amd loving smile. Even during the adminstration of anesthesia, stroking their arm or singing a song is very soothing. Do not be alarmed by the fact that the child is falling asleep - that's what's supposed to happen. Reluctant or rebellious facial expressions on the child are normal.

4. Waking Up in A Parent's Arms - At this point, a nurse will accompany you to the waiting room until the end of the surgery. During long operations, a nurse will keep you updated during the course of the surgery. As soon as the child reaches the recovery room, you will be called so they can wake up in a parent's arms. At that point you will receive a report from the surgeon regarding the operation and from the anesthesiologist about the anesthesia. You will also be taught how to proceed through the various stages of awakening, possible pain and the right time the child can start drinking and eating again.

We hope this information will remove concerns you may have towards your child's surgery and encourage you to take an active part in our attempt to turn the operative period into a positive, and healing experience.

Wishing you a speedy recovery!

Department of Anesthesiology, Unit for Pediatric Anesthesia
Phone: 02-677-7048, 02-677-7719