Patients Info: Anaesthesia: Pre-Med

PRE MED

  • Unless your child is very ill, I will prescribe a sedative drug to be given orally when the trolley for theatre comes to fetch him/her from the ward.
  • Do not allow them to run around after they have had the pre med, it makes them drowsy and they may fall and get hurt.
  • The level of sedation varies from child to child, some are very sleepy, others a bit silly and others only slightly quieter than usual.
  • The pre med makes the child forget most of the experience of going to theatre, and takes away most of the anxiety.

 

GOING INTO THEATRE WITH YOUR CHILD

  • I prefer one parent to come to theatre with the child.  Although this can be a traumatic experience for the parent, it avoids distressing the child by wrenching it from the parent at the theatre entrance.
  • Once we are in theatre, we apply some monitors, they do not hurt or cause discomfort to your child.  We then ask the child to breathe oxygen and anaesthetic gas from a face mask. 
  • The child starts falling asleep, and then goes through the “second stage” of anaesthesia.  During this stage, they may breathe funny, or start flailing about.
  • Do not be alarmed.  The child would not remember the experience as they are already partially asleep.  It is a normal phase of going to sleep with anaesthetic gas.  In adults, we put up a drip before starting anaesthesia, and the intravenous drugs make them go to sleep much faster than with the gas.  Hence, “second stage” effects are not observed.
  • The drip is inserted once your child is fully asleep, to limit pain and distress for the child.
  • While the child is asleep, we also insert suppositories into the rectum to help abolish post op pain.
  • WE DO ALL WE CAN TO MAKE THE EXPERIENCE AS STRESS FREE AS POSSIBLE FOR THE PARENT AS WELL.
  • IF YOU DO NOT WANT TO GO INTO THEATRE, PLEASE DO NOT FEEL OBLIGED TO DO SO.  A fearful fainting parent does not reassure a child.
  • When asked to leave theatre, please do so directly.

 

AFTER SURGERY

  • I will administer pain medication to your child while I am conducting the anaesthetic.
  • Your young child may be crying after waking up from anaesthetic.  There will be additional pain medication prescribed to take home with you, if your child has pain on waking up, this medication may be started directly.
  • I also prescribed medication for nausea and vomiting.
  • The potent drugs used for pain in theatre have as a side effect itching of the nose, do not be alarmed if your child rubs their nose vigorously.  This is not a manifestation of a drug allergy.
  • Unless there is a good reason for keeping the drip up, it will be removed as the child leaves theatre.

 

EATING AND DRINKING

  • Offer the child something to eat or to drink once he/she is awake.  Do NOT FORCE the child.  If they do not want anything, try again later.  Forcing them will cause nausea and vomiting.
  • Wait for the surgeon to come and discharge your child before leaving the hospital, and check with the Sister in charge of the ward before leaving.
  • Remember to take the medication prescribed with you!

 

“FLU”, FEVER, COUGING OR VOMITING

    • If your child becomes ill before the planned date of surgery, surgery may have to be postponed.
    • Coughs and colds may be an indication to postpone surgery, as the airways of children (and adults to a lesser degree) become sensitised by these illnesses and the risk of anaesthesia is increased.
    • Some children never get over the runny noses, painful ears and tonsillitis until the problem is solved by an operation, in these kids, I will go ahead with the anaesthetic.
    • We may have to keep these children for some time after surgery, or even over night for observation and treatment.