Paediatric (Child) Surgery

When a child needs to have surgery it is an important and often frightening time for both the child and their carers. A hospitals stay can be a positive experience for your child and yourself. Parents and carers have an important part to play in making the experience as non-threatening and positive as possible. Depending on the age of the child, the amount of information that you need to give them will differ. The most important thing is to truthfully tell the child where they are going and that you will either be with them, or very close, to them at all times.

Before Your Operation

Why can't I give my child breakfast or a drink?

Nobody likes to be hungry, especially children when they don't understand why. It is very important that you do not give your child, or allow them access to food or drink, from the time your doctor or the nurse tells you. If your child does eat or drink anything their operation may be cancelled or postponed. The reason for this is that when anaesthetised, the stomach stops working and the cough and other protective reflexes also stop working. If there is food or fluid in the stomach, this can run back into the mouth and down into the lungs. This can cause serious problems and requires emergency treatment. Ask your doctor or the Paediatric Unit nursing staff how long your child will need to fast before surgery.

What do I need to tell the anaesthetist?

Your anaesthetist will want to know a lot about your child's medical and surgical history and perhaps even some of your family medical history.

Some of the things you may be asked include:

When your child last ate or drank
Recent coughs or colds
Previous anaesthetics or family history of problems with anaesthetics
Drug or food allergies or reactions
History of medical problems such as heart problems, diabetes, asthma or bronchitis
Loose teeth or braces
Medications your child has or is on at the moment.

What is the white cream on my child's hand for?

The white cream is called EMLA and is applied to the back of the hand with a waterproof dressing over. This cream slowly penetrates the skin and numbs the upper layer. After about an hour, the skin is anaesthetised and the pain that your child may feel when the intravenous needle is inserted in theatre will be greatly reduced. Sometimes the child will feel nothing at all.

Why do I have to get changed into those funny blue pyjamas to come with my child into theatre?

Patients and families sometimes wonder at the funny clothes we wear in the operating suite. We wear special clothes to limit the number of micro-organisms introduced into the operating suite environment. Our hair is covered and we wear blue dresses, or pants and tops. We also wear shoe covers or shoes that are worn only in the operating suite. When you come into theatre with your child you need to wear these clothes also. The Paediatric Unit staff will give the clothes to you in the unit, so that you and your child can get changed together.

How do we get to the operating theatre?

When it is time for your child's surgery, your child can drive themselves around in our special car. You and the Paediatric nurse will come also! The other way to come to theatre is on a bed trolley.

Can I stay with my child when they are in surgery?

At Albury Wodonga Health - Wodonga Campus parents are encouraged to stay with their children until the child has been anaesthetised. There is no set rule, and if you do not feel comfortable or able to stay with your child please inform the nursing staff or your doctor so that they are prepared to take over comforting your child for you. At times the decision is made that a parent cannot accompany their child. This may be because of emergencies occurring in the operating suite, or your child may be too ill to benefit from your company. Whatever the reason you, and your child, if appropriate, will be given an explanation. Once your child is in the recovery area, and awake and stable, you will be able to see and cuddle them.

During the Operation

Once your child has been anaesthetised, or is sedated and comfortable enough for you to leave, the nurse will show you the way out of the operating suite. This is a good time to go and have a drink and something to eat. You may not get time later, and your child will need you to be strong, not weak and fainting from hunger!

You can return to the Paediatric Unit and change back into your own clothes. The nursing staff will direct you to the cafeteria.

After the Operation

Once the surgery is completed your child will be transferred to the recovery area. This is called the Post Anaesthetic Care Unit and your child will remain here until the nursing staff are happy that their condition is stable and that their pain is under control. The nursing staff will wait until your child is sufficiently awake to benefit from your company before calling the Paediatric Unit to let you know to come around. Rarely, there are occasions that a parent cannot come into the recovery area. If this is the case you will be given an explanation and informed of your child's condition. We aim to have you and your chid together as soon as possible.

Paediatric Anaesthesia

General Anaesthesia

A general anaesthetic is a state of deep and controlled sleep brought on by the special drugs and gases. This is done so that surgery is painless and the patient is unaware. The anaesthetist may put a small drip into your child's arm and inject a special medicine into the drip tubing that will put your child to sleep. Another way that children can go to sleep is by breathing a mix of special anaesthetic gases through a mask. This is where we ask the child to blow up our special balloon. Refer to the slide show for a picture of this.

If you feel comfortable, and have discussed accompanying your child to theatre with your doctor, then the paediatric unit staff will get you changed with your child into the blue scrub suits that are required to be worn in the operating suite. Regardless of whether you accompany your child, be assured that the anaesthetist, surgeon and perioperative nursing staff will remain with your child at all times and offer the comfort and support that they need.

Regional Anaesthesia

This includes spinal and epidural anaesthetics. An anaesthetising drug is injected into the nerves that supply a particular part of the child's body. This ensures that the area being operated on is numb and without feeling. A general anaesthetic is usually also given with this type of anaesthetic.

Local Anaesthesia

Local anaesthesia can be used for minor procedures or as a way of reducing pain to the operation site after surgery. A local anaesthetic (similar to what the dentist uses) is injected into the skin area around the site to be numbed. This is usually done when the child is asleep.

Intravenous Sedation

Intravenous sedation can be used for minor procedures where a general anaesthetic and deep sleep are not required. The sedative drug is injected into the drip tubing. Intravenous sedation can be used where a local anaesthetic is to be used and will ensure the child is asleep before the local anaesthetic is injected.