The Day of Surgery

Anesthesia (anesthetics) is medicine that prevents the feeling of pain during a procedure or surgery and prevents you from remembering.

A few types of anesthesia are:

• General anesthesia – keeps a person completely “asleep” (unconscious) during a procedure or surgery
• Local anesthesia – numbs only the procedure or surgical site
• Regional anesthesia – numbs a larger area of the body, including the procedure or surgical site(s).
• Sometimes a combination of these is used.

If you have questions about anesthesia alternatives, you may ask the anesthesiologist about options. Nationwide Children’s Hospital staff specializes in giving anesthesia to infants, children and adults. They will choose the safest form of anesthesia to use.

All general anesthetics are given by members of the Department of Anesthesiology & Pain Medicine.

The anesthesia staff includes doctors specializing in anesthesia (anesthesiologists) and certified registered nurse anesthetists under the direct supervision of the anesthesiologists.

 An anesthesiologist will talk to you about the anesthesia and answer any questions you may have. If you have any questions or concerns about the anesthesia before the day of the procedure or surgery, please call your surgery location.

Some patients worry about the possibility of getting shots before they are asleep. There may be different reasons for getting medicine before a procedure or surgery.

• If your child is nervous or anxious before the surgery or procedure, a sedative may be needed before anesthesia to calm them. It is usually given in the form of liquid to swallow.
• Teenagers and adults may have an intravenous (IV) catheter placed in a vein for an injection if sedation is needed for anxiety.

Talk to the anesthesiologist about options.

• In most cases, younger children inhale a medicated air through a mask that covers the nose and mouth. Your child may choose a scent for the mask. After 1 to 2 minutes, your child will be asleep (anesthetized). After your child is anesthetized, an intravenous (IV) catheter will be placed so fluids and medicines may be given.
• Older children, adults, and some children with medical problems may need IV medicines to “go to sleep” instead of the air. You may or may not get the chance to choose what you would like depending on the situation. The anesthesiologist will make the final decision based on what is safest and discuss it with you.
• A member of the anesthesia team will stay with the patient during the entire procedure or surgery to watch vitals signs.

The patient will wake up and recover in the Post Anesthesia Care Unit (PACU).

The PACU nurses are specially trained in this type of care. A pediatric anesthesiologist is always close by if there are any problems. Recovery times are different based on the procedure or surgery. The goal is to have the patient awake and back with family as soon as safely possible.

If you or your family have any questions or concerns during or after the procedure or surgery, please ask staff for an update.

Some people will be nauseated or may throw up (vomit). Children having eye surgery or tonsillectomies are more likely to have this problem. If this happens, medicine can be given for the nausea and vomiting.

If a breathing tube was put into the mouth and throat, the patient may have a sore throat or hoarseness for a few days. There may be a small puncture mark or bruise where the IV was removed. At times, there may be more than one puncture mark because it may take more than one try to get the IV in place.

Children handle the hospital experience in a variety of ways.It is not uncommon that your child may:

• Start doing behaviors they used to do (regress)
• Have trouble being away from you
• Become more dependent on adults than they were before
• Have sleeping and eating pattern changes

These changes are usually short-term. If you have any questions or concerns, please talk to the doctor at the phone number written on your discharge instructions.

A procedure or surgical site infection can happen on or in the body where a cut was made during a procedure or surgery.

Some of the symptoms* of a site infection are:

• Redness
• Increase in pain
• Cloudy drainage
• Fever of 101 degrees F (38.3 degrees C) or higher

*Call your doctor if the patient develops any of these symptoms.

You can help prevent infection by:

• Always cleaning your hands before and after caring for the wound(s)
• Not letting anyone else touch the wound(s)
• Staying away from anyone who is not feeling well. This includes close family.
• Visitors should clean their hands with soap and water or an alcohol-based hand gel before and after visiting.

It is not unusual to feel sleepy and/or unsteady after getting anesthesia. To prevent injuries:

If the patient is a young child:

• We highly recommend that one adult ride in the backseat with the child while a second adult drives home.
• Use a car seat or a booster seat before and after the procedure or surgery, as age appropriate.
• Watch and help your child after the procedure or surgery.
• Do not allow your child to operate a motorized vehicle or ride a bike for 24 hours. This time may be longer depending on the doctor’s orders.
• Quiet, indoor activities are best.

If the patient is a teen or an adult:

• Arrange for someone to be with you for the rest of the day.
• Do not sign important documents for 24 hours.
• Do not operate a motorized vehicle or a ride a bike for 24 hours. This time may be longer depending on the doctor’s orders.
• Quiet, indoor activities are best.