(BPT) - Key takeaways:
- Parents and caregivers can help prepare a child for surgery by following fasting and medication instructions and sharing complete information about the child's health.
- CRNAs, also known as nurse anesthesiologists or nurse anesthetists, provide anesthesia and pain management before, during and after procedures, including continuous monitoring during anesthesia.
- Visit AnesthesiaAnswers.org, a resource from the American Association of Nurse Anesthesiology (AANA), for practical information, questions to ask and recovery tips.
Facing a child's surgery can bring many questions. To help families find clear, practical information, the American Association of Nurse Anesthesiology created AnesthesiaAnswers.org, an online resource about anesthesia, procedures and recovery.
AANA represents Certified Registered Nurse Anesthetists (CRNAs), also known as nurse anesthesiologists or nurse anesthetists, who provide anesthesia and pain management before, during and after procedures.
To help families prepare, AANA offers the following guidance about what to expect before, during and after anesthesia.
What to know before surgery
You play an essential role in your child's safety because you know them better than anyone else.
"Parents are an important part of the anesthesia safety team," said Suzanne Wright, PhD, CRNA, FAANA, chair of AANA's Patient Safety Advisory Panel. "Follow your child's preoperative instructions carefully, and never hesitate to ask questions. Knowing when your child last ate, drank, or took medication, for example, can make a meaningful difference in keeping them safe during anesthesia."
Parents will receive specific instructions for their child about when to stop eating and drinking. Following these instructions exactly helps reduce the chance that food or liquid in the stomach could enter the lungs under anesthesia, a serious complication called aspiration.
What should I know before my child gets anesthesia?
Before surgery, a CRNA or other anesthesia professional will review when your child last ate or drank, discuss your child's health and assess their airway. Tell the CRNA about any current or recent respiratory illness — including a cold, flu or COVID-19 — and symptoms such as coughing, congestion, fever or wheezing, even if your child seems to have recovered. Recent respiratory infections can leave a child's airway more sensitive for several weeks and may increase the risk of breathing problems during or after anesthesia. Sharing this information helps the anesthesia team assess your child's individual risk and determine whether any changes to the anesthesia plan or timing of an elective procedure should be considered.
The CRNA will:
- Confirm past experiences: You'll be asked how your child has done with anesthesia before and about family history of rare reactions.
- Review anesthesia plan: They will explain the plan, introduce the anesthesia professionals caring for your child and review consent forms.
- Ease anxiety: Children may receive medication to help them relax by mouth, through the nose or through an IV, depending on their age. Child life specialists may be available to help reduce anxiety.
The most important thing to do before surgery is to follow all your healthcare provider's instructions.
Throughout the procedure, a CRNA stays with your child, continuously monitoring vital signs, managing anesthesia and responding to changes.
What to expect during surgery
Parents typically wait in a designated area while children are taken to the operating room. A nurse and a CRNA will help your child move safely onto the operating table. Your child may be comforted by warm blankets, music, a tablet or a child life specialist.
While this is a stressful day for your child, it's also important to care for yourself.
What a CRNA does during surgery
Depending on your child's age and anesthesia plan, an intravenous (IV) line may be placed before anesthesia begins or after your child is asleep. It may be used to:
- Administer anesthesia
- Give fluids
- Deliver antibiotics and medications to prevent nausea/vomiting
Once your child is under anesthesia, the CRNA may place a breathing tube or other device to support their breathing.
Throughout the procedure, a CRNA stays with your child, continuously monitoring vital signs, managing anesthesia and responding to changes. CRNAs support pediatric patient safety by:
- Measuring medication amounts based on the child's weight
- Using equipment that fits the child's size
- Continuously monitoring breathing, heart rate, blood pressure and oxygen level
- Having emergency medicines ready if needed
How a child recovers after surgery
After the procedure, the CRNA will begin the waking process. The team will take your child to the recovery room, where they will be monitored closely. The nurse and CRNA collaborate to ensure pain is addressed, and medications to treat nausea and pain may be given through the IV.
Children wake from anesthesia at different rates. Some wake quickly, while others take longer and may initially be sleepy, confused, restless or tearful. These reactions are often temporary and usually improve as the anesthetic wears off. When it is appropriate for the procedure and your child's recovery, the recovery nurse may offer clear liquids.
Going home
Your child's healthcare team will determine when your child has met the appropriate criteria to go home. Children undergoing major surgery or with complex medical histories may require a hospital stay after their procedure.
Before going home, you'll receive aftercare instructions. Follow them closely, including giving medications as prescribed and scheduling follow-up appointments.
For more information about anesthesia, questions to ask before a procedure and tips for supporting your child's recovery, visit AnesthesiaAnswers.org.
Note: Depending on the facility and care setting, your child's anesthesia may be provided by a CRNA or another qualified anesthesia professional.
