Post-anesthesia for Toddlers?

May 5, 2008 8:35 PM

My baby boy will undergo general anesthesia Thursday. What should I expect when I get him home?

My 20-month-old son will undergo an outpatient procedure to repair 2 inguinal hernias on Thursday.

I'm stressing of course, but the doctors assure me that Henry will be fine. (They've done thousands of these operations; the hospital is excellent and the procedure involved but relatively uncomplicated.)

Parents or Caregivers:
Are there any side-effects, or latent effects of anesthesia I should know about?
What will the 24-48 hours after the surgery be like?
Any secret tips to make him extra-comfortable?
Yikes.

posted by Dizzy to health & fitness (10 comments total)

My son had heart surgery when he was less than a year old- and 2 hours after the surgery, he was all puffy, but he was alert and wanting to play. A bit groggy, but still happy. The next day, he was back to normal, as if nothing ever happened.
posted by bradth27 at 8:51 PM on May 5, 2008

My son, now 18 months, had an outpatient surgery performed on him at 6 months (mild hypospadias repair). I was able to go with him into the operating room to hold him while the anesthesia was administered (probably one of the toughest parts for me). After the surgery, my husband and I were brought into the recovery area, where a nurse was trying to comfort our son, who was inconsolably crying -- I was told this was a totally normal reaction to the anesthesia. I held him for a long time until he calmed down, then was able to feed him which helped as well. Maybe an hour later we were on our way home, and our son was groggy but calm in his car seat. He was playing, albeit a little less rambunctiously than usual, that same afternoon. We didn't find there were any special things we had to do pertaining to the anesthesia, more for the care of his surgical site, administering medication, etc.

I'd just say to make sure you bring a favorite stuffed animal or lovey to the hospital (don't force it on him after the surgery, though, if he's too upset to focus). And check with your doctor about any restrictions on milk, snacks, etc. If there's some music your son likes, bring the CD for the car ride home. And make sure you have comfortable pajamas (maybe one size up depending on how his surgical site will be dressed, or even a zip-front sleeper) and any blankets he really likes. A couple of new toys wouldn't be a bad thing; your doctor has probably told you if there will be any restrictions on your son's mobility after the surgery (for example, we had to temporarily set aside any ride-on toys, and so we bought a few extra floor-type toys to entertain our son). And maybe a couple of DVDs of your son's favorite programs, if you're not against it.

On a side note, I know this is a really stressful time and it's hard to anticipate your little one suffering. For what it's worth, I really was amazed at how quickly our son recovered, and how resilient he was during all the discomfort of the recovery. This is likely to be tougher on you than him! I'll be thinking of your family on Thursday.
posted by justonegirl at 9:42 PM on May 5, 2008

Our daughter had to be knocked out for some dental work, and she also cried when she woke up. I think she was just really confused and woozy. She stopped after a few minutes, though, and was just a little groggy for the rest of the day.
posted by Addlepated at 11:44 PM on May 5, 2008

I feel your pain. My son underwent an outpatient inguinal hernia repair at the age of 4 months. The most difficult part for me was handing him over to the O.R. nurses. I had worked at this hospital since I was 19 years old. At the time of his surgery I was 33. I knew all of these people. It didn't make it any less difficult. Just know that these people taking care of your baby are professionals. They will take care of your child as if he were their own. As far as post-anethesia goes, your child will be sleepy/groogy for at least 24 more hours. My son never appeared to be in any pain. In fact, he seemed to be relieved having the hernia repaired. I realize there's a big difference between 20 months and 4 months, but just trust your instincts. Wrap him in a blanky and rock him. He will be fine. Justonegirl is so spot on, it will be tougher on you than him. I'll keep your family in my thoughts as well.
posted by wv kay in ga at 11:58 PM on May 5, 2008

My son was under general anesthesia when he was two years old to correct an undescended testicle. He was groggy, but perfectly fine, after we brought him home. As noted above, make sure you devote plenty of time to comforting him, cuddling him, etc., after he gets home.

Best wishes to you and your son.
posted by amyms at 12:00 AM on May 6, 2008

This is a very common procedure and he should do fine; but I know nothing anyone says will do any good until you actually see him in the recovery room. I do anesthesia for these all the time, and there are several things we look for in the recovery room. First of all, he will be groggy, especially at first. How quickly he wakes up can be quite variable, depending on a number of factors, such as the types of drugs used in the OR and whether he is on any medicines preoperatively. Many children are fussy postoperatively, sometimes this can progress into full-blown emergence delirium where the patient essentially throws a tantrum and is inconsolable for a period of time. This gets better with time, but it is upsetting to parents who aren't expecting it. Fortunately it is not real common and there are things we can try to do to treat it. Pain control is another concern; it is certainly reasonable to ask the surgeon and anesthesiologist what their plans are ahead of time. The surgeons I work with inject local anesthetic into the incision at the end of the case, so the patients wake up nearly pain free; I generally give a little narcotic and/or tylenol to help with any pain the local doesn't take care of. Nausea is a concern of a lot of parents, but in this age group and for this surgery it is actually not very common. In our hospital we give them something to drink in the recovery room to try and make sure they are holding things down before they go home. If there is a problem with vomiting, we have a variety of treatments and we make sure they are well-hydrated with IV fluids before they leave. Rarely if someone has severe pain or nausea we will admit them, but that is very uncommon (I can't recall the last time it happened here). If your child has any pre-existing health problems they may be made worse by the surgery. In particular children with asthma or a respiratory infection may have some breathing problems in the recovery room. These are usually minor and the staff is used to dealing with them (asthma is very common these days) so they usually don't prolong the recovery. In general after he goes home just treat him like you would if he had a cold; let him rest and watch TV, make sure he has plenty to drink, if he is hungry fix him something he really likes as a treat, and so on. My 3 year old daughter has had a couple of procedure under deep sedation (very close to general anesthesia) and after her afternoon nap she was pretty much back to normal. By the next day you couldn't tell she had had anything done.

I see you are near Boston from your profile; there are obviously some excellent hospitals there and yours may well have some information on their website. The Society for Pediatric Anesthesia also has a section for parents on their website, but it seems to be down right now so I can't link to it. Anyway, I hope this helps; if you have any other questions or want a clarification, feel free to send me an email.
posted by TedW at 5:59 AM on May 6, 2008

The thing that surprised me when my son had general anesthesia to have ear tubes put in at 15 months old was how cranky he was afterwards. Apparently some kids wake up from anesthesia cranky. Because I was the one who brought him to the hospital, he was pissed at me for weeks afterwards. He was pretty pitiful that day too. We relaxed all the rules. Want to watch the same teletubbies episode 7 times in a row? Eat nothing but dry captain crunch all day? No problem. By the next day he was back to himself (except for being mad at me).

I had the opportunity to talk to the anesthesiologist before the procedure, which was a great help. She told me the anesthetic they use (sevofluorane) has a fast onset and wears off fast. She warned me he might be cranky. Mainly the benefit of talking to her was to see for myself that she appeared sane and competent and my baby was in good hands. I started off the conversation by saying, "the anesthetic is the part of this that worries me the most," and she said, "it should" - which, oddly enough, was the most comforting thing anyone had said. I felt like she took it all seriously.
posted by selfmedicating at 8:32 AM on May 6, 2008

My kid was very clingy/needy after surgery. He would stick to my shoulder like glue, then pitch a fit to be let down, and another fit to immediately be back on my shoulder, and another fit when I picked him back up, and another fit when I breathed, etc. It was his first temper tantrum (at age 4) and because he'd never tantrumed before (easiest kid ever I swear), that was the real surprise. His stomach hurt alot, but he never threw up.

The hospital personnel were great though. They told me what to expect and gave me worst case scenario. I expected a lot of vomiting and pain. They let him play with the gas mask thingy and wheeled him off in a red wagon. They tried to make it a little fun for him.

When we got home, he watched tv until he fell asleep and I left him sleeping on the sofa for the night. I would have let him have anything he wanted, but milk. He gets ill sometimes on milk, so I didn't want to risk that. But, his only real wants were a little koolaid, sofa, and Blues Clues (remember Steve?). The next morning, he was normal as usual. So, altogether, I'd say he was extremely irritable, clingy, and irrational, but fine after a long night's sleep.
posted by ick at 10:12 AM on May 6, 2008

Hey Kind Answerers;
Success!
He was crabby and groggy yesterday afternoon, but by sundown starting to become his smiley self again.
This morning I can tell by his gait that he's a little sore, but we're dosing with Motrin. He's hungry, he's playful, he's Henry.
Man, was I scared.
Thank you for your help!
posted by Dizzy at 6:05 AM on May 9, 2008

Glad things went well; having good parents helps a lot.
posted by TedW at 2:41 PM on May 9, 2008