1 Pre-operative preparation for anaesthesia and surgery

When anaesthetizing a child one is anaesthetizing the entire family! It is important to provide detailed information regarding how you as the anaesthesiologist will provide the safest possible care for their child. Alleviating parental anxiety will alleviate patient anxiety.

During the pre-operative visit, the anaesthesiologist performs the physical examination while assessing abnormalities of the airway and the patient's level of anxiety and response to strangers. The anaesthesiologist determines the need for a pre-anaesthetic medication and whether the child might benefit from parents accompanying them to the operating room. Further preparation includes haematological evaluation for children less than 6 months of age; anaemic former preterms are particularly susceptible to apnoea. Underlying medical problems require appropriate evaluation. Review of past anaesthetic records helps determine difficulties with previous laryngoscopies as well as adequacy or inadequacy of previous pre-medication.

It is important to describe to the child that the sleep caused by anaesthesia is different than sleep at home. The sleep induced by anaesthesia is such that the child will not feel anything, will not remember anything, will not awaken during the operation but, when the anaesthetic gases are removed, they will awaken and return to their parents. Discussion regarding post-operative pain relief will comfort the child and family.