Anesthesia: What to Expect

When their child needs anesthesia for a procedure or surgery, parents usually have a lot of questions. Here’s what to expect before, during, and after a child has anesthesia. 

What Are the Types of Anesthesia?

The anesthesia used depends on the procedure or surgery being done. It also depends on the child’s age and any medical conditions they may have. The types of anesthesia are:

• General: the child would be "asleep"
• Regional: one large area of the body is numbed
• Local: one small area of the body is numbed

General and regional anesthesia are used in hospitals and surgery centers. These medicines are given to patients by specially trained doctors (anesthesiologists) or nurses (nurse anesthetists). Health care providers can give patients local anesthesia in doctors’ offices and clinics. Sometimes, a patient gets a combination of different types of anesthesia.

What Happens Before Anesthesia?

Before your child gets any kind of anesthesia, you’ll meet with the doctor or nurse. To help them decide what kind of anesthesia to use, they’ll ask about your child’s medical history, medicines, drug or alcohol use (for older kids and teens), and allergies. They will also ask if anyone in the family has ever had a problem with anesthesia. It’s important to answer these questions as thoroughly as possible.

The doctor or nurse will examine your child and may order some tests (such as X-rays or blood or lab tests).

The doctor or nurse will tell you when your child should stop eating or drinking before getting the anesthesia. Your child also might need to stop taking medicines. It can be hard for kids to not eat or drink when they want to, but it’s important to follow the instructions exactly. If they eat or drink too close to the time of the anesthetic, food or drink in the stomach could be inhaled into the lungs and cause serious problems. Do encourage your child to drink clear fluids up until the cutoff time, though.

What Happens During Anesthesia?

What happens during anesthesia depends on what type is used:

General anesthesia: A patient who gets general anesthesia is completely unconscious (or "asleep"). They can’t feel any pain, are not aware of the surgery as it happens, and don’t remember anything from when they are “asleep.” Patients can get general anesthesia through an IV (into a vein) or inhale it through their nose and mouth. A tube is placed in their throat to help the person breathe while they are under general anesthesia. 

Regional anesthesia: This type of anesthesia may be injected near a cluster of nerves in the spine. This makes a large area of the body numb and unable to feel pain. Common types of regional anesthesia include epidurals (often used in childbirth), spinal blocks, and peripheral nerve blocks (when the medicine is injected neara nerve or group of nerves to block feelings of pain in a specific area of the body). The anesthesiologist will decide which type of regional technique is right for your child.

Local anesthesia: Local anesthesia numbs a small part of the body (for example, a hand or patch of skin). It can be given as a shot, spray, or ointment. It may be used for dental work, stitches, or to lessen the pain of getting a needle.

Sometimes, a child gets sedation before the IV is placed or anesthesia is given. This medicine, given by mouth or as a nasal spray, helps them relax and feel sleepy.

Before they give a child anesthesia, doctors and nurses will work with the child and their parents to ease any fears. No matter what type of anesthesia your child gets, they will be constantly checked to make sure they're comfortable and safe.

What Happens After Anesthesia?

Children need time to recover after anesthesia. 

After local and regional anesthesia, the numb area will slowly start to regain sensation again. Your child may then start to feel some discomfort there. Depending on the procedure and whether sedation was used, your child might be able to go home within a few hours.

Kids who have general anesthesia go to the PACU (post-anesthesia care unit) after their procedure or surgery. In the PACU, doctors and nurses watch kids very closely as they wake up. Parents usually can join their child in the PACU. Expect your child to be sleepy for an hour or so. Some kids feel sick to their stomach, irritable, or confused when waking up. They may have a dry throat from the breathing tube. 

After your child is fully awake and any pain is controlled, they can leave the PACU. Some kids go home that same day and others stay in the hospital. Most hospitals let a parent stay with their child in the hospital.

Going Home

Your doctor or nurse will talk to you before you take your child home. They will tell you when to follow up with your health care provider, what pain medicines to give (if any), and things to watch for.

Call your health care provider if your child:

• has bleeding, redness, or pus where the procedure was done
• has a fever higher than 101°F (38.3°C)
• has pain that is not helped by the prescribed medicines or has severe pain
• can't take fluids by mouth
• is vomiting

How Can Parents Help?

Anesthesia is usually very safe and most kids have no problems. Some research says that general anesthesia or being sedated for a long time in children under 3 years old can lead to changes in brain development. But more recent data is reassuring. Long-term studies to investigate this continue. Talk with your health care provider if your child is younger than 3 and you have concerns about them getting anesthesia.

Other questions you may want to ask:

• Can I be with my child before surgery? When do I have to leave?
• What kind of anesthesia will my child get? Will my child need breathing support?
• How will the anesthesia be given — with a needle, through an IV, mask, or breathing tube?
• Will my child be sedated before getting the anesthesia?
• How long will the surgery take?
• How long will it take my child to fully wake up from general anesthesia or feel the area if local or regional anesthesia was used?
• How soon after the surgery can I see my child?
• How soon after the surgery can my child eat, drink, go to school, or drive (if you have a teen)?
• How soon after the surgery can my child come home?

Knowing what to expect and having your questions answered before the procedure or surgery will help you and your child feel more comfortable.