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3. Anesthesia for Children Having Eye Surgery

Print Version

WHAT KINDS OF ANESTHESIA ARE THERE FOR CHILDREN HAVING EYE SURGERY?

 
There are two main types of anesthesia: local and general.
 
Local anesthesia numbs a specific area using medicine. Sometimes the medicine is injected with a needle or put on the area for surgery. For example, dentists use local anesthesia to operate on teeth. The person having surgery stays awake, can move and is aware of the procedure. 
 
General anesthesia puts the whole body to sleep. People cannot move, are not aware of what is happening, and do not feel pain during the surgery.
 
For eye surgery, especially in children, general anesthesia is often used to keep them safe and still. General anesthesia is also sometimes needed for a complete eye checkup for a child who is not able to do a full eye exam in the office. 
 
Sometimes, small eyelid procedures can be done under local anesthesia for older children who can stay still and calm.   
 

HOW IS ANESTHESIA GIVEN TO CHILDREN?

 
General anesthesia is usually given to children in two stages. First, a relaxing gas medicine is given through a face mask, causing the child to fall asleep. An intravenous (IV) line is usually placed in a vein of the arm or leg after a young child is asleep, this is to give other medicine for the surgery. Older children may have the IV line placed before going to sleep.
 
Sometimes, for short procedures, like opening a blocked tear duct, only the mask is used. But, for most eye procedures, a special breathing-tube called an endotracheal (ET) tube or laryngeal mask airway (LMA) is placed in the windpipe. This tube helps the doctors control the child’s breathing and give the anesthesia safely. Medicine through the tube and the IV keeps the child asleep for the surgery. The breathing tube is taken out at the end of surgery before the child is fully awake. The IV can be removed in the recovery area once the child is drinking well and feeling well. Figure 1 is a photo of an endotracheal tube.

Endotracheal Tube

Fig. 1: Endotracheal Tube

HOW IS ANESTHETIC “SLEEP” DIFFERENT FROM NORMAL SLEEP?

When a child is under anesthesia, it's different from regular sleep. The powerful medicines used affect the whole body. The anesthesiologist knows which medicines are best for the child and adjusts the medicines to keep the child comfortable and safe during surgery. 
 

HOW SHOULD YOU PREPARE A CHILD FOR SURGERY?

If your child is old enough to understand they are having surgery, it is important explain it to them so they feel comfortable. If the child is very young, staying calm and cheerful is helpful. Hospitals and surgery centers sometimes have services like Child Life to play and talk with children before surgery, making them feel more comfortable. Don't hesitate to share your questions or concerns. The staff, nurses, and doctors are there to make the surgery experience a positive one for your child. 
 

IS A MEDICAL EXAM NEEDED FOR CHILDREN BEFORE UNDERGOING GENERAL ANESTHESIA?

Yes. Before surgery a medical history and physical exam is needed to be sure the child is enough for the anesthesia and the surgery. This may be done by the child’s primary care physician, the anesthesiologist or the ophthalmologist.
 

DO ANESTHESIA PROBLEMS TEND TO RUN IN FAMILIES?

Yes, certain reactions to anesthesia can run in families. There are also medical problems that run in families that can cause problems with anesthesia. It is important to talk with your child’s anesthesiologist about any bad reactions to anesthesia that happened to your child or your child’s relatives. There are ways to handle problems from anesthesia, including medicines that can be given to help. It is important to share any concerns with your medical team so they can you’re your child safe during surgery. 
 

WHAT CAN A CHILD EAT OR DRINK BEFORE GENERAL ANESTHESIA?

Before surgery with general anesthesia, patients must not eat or drink for a certain time, usually 4-8 hours. The exact time depends on the patient's age and the type of food or drink. The hospital or surgery center will give specific instructions for your child.
 
It is important not to eat or drink before surgery because having a completely empty stomach helps avoid problems like aspiration. Aspiration is when whatever is in the stomach gets breathed into the lungs, and it can cause serious problems like pneumonia. Not eating or drinking can be hard for anyone, especially children, but it’s important for their safety. 
 
The hospital staff will tell you what time your child must stop eating and drinking. Please follow these instructions carefully to avoid delaying or canceling the procedure.
 

CAN A MEDICINE BE GIVEN TO CALM A CHILD BEFORE GOING INTO SURGERY?

For some surgeries, hospitals might give children a liquid medicine to calm the nerves and help with anxiety before the operation. This medicine can also help them forget the events right around the surgery but it may take the child longer to wake up from anesthesia. Please talk with your child’s anesthesiologist about what is best for your child’s surgery.
 

ISN’T GENERAL ANESTHESIA DANGEROUS?

No. Patients are closely watched by the anesthesiologist while they are asleep. Serious reactions to anesthesia are very rare. Every safeguard is taken to keep the child safe while they are asleep.

Teddy bear with Anesthesia Mask

Fig. 2: Parents can explain surgery to children who are old enough so that they understand why they are having surgery.

 

WHAT IS A LARYNGEAL MASK AIRWAY (LMA)?

A laryngeal mask airway (LMA) is a special breathing tube placed on top of the vocal cords but not going past them like the other breathing tube/endotracheal tube (ET). This can help lessen irritation in the windpipe during surgery and lessen sore throats afterward [see figure 3]. LMAs are not good breathing tubes for every surgery. Your ophthalmologist and anesthesiologist will decide which tube is right for your child’s surgery. 

Modern Anesthesia techniques often include special breathing tubes that reduce irritation to the windpipe during surgery.

Fig. 3: Newer forms of Anesthesia often use special breathing tubes that can lessen irritation to the windpipe during surgery.

 

CAN A PARENT BE WITH THE CHILD WHILE ANESTHESIA IS GIVEN?

Every hospital and surgery center has its own rules about parents being with their child when they go to sleep in the operating room or wake up in the recovery room. Please ask your ophthalmologist about the rules where they operate.
 

WHAT HAPPENS DURING THE RECOVERY FROM GENERAL ANESTHESIA AFTER SURGERY?

After surgery, the anesthesiologist helps the child wake up which might take a few or more minutes. When it is safe, the breathing tube is removed and the child breathes normally again. They are then moved to the recovery room. In the next hour or so, the child slowly wakes up. During this they might feel groggy, cranky or confused. The recovery room staff takes good care of the child, checking heart rate, blood pressure, pain level and breathing. 
 
In the next few hours the child will still be sleepy, a bit moody, and uncomfortable. The staff gives support and if needed, a mild pain medicine from the ophthalmologist or anesthesiologist. Most children can go back to their usual activities the next day. Sometimes, a child might sleep for hours after a surgery, especially after a long surgery or if they need extra pain medicine.
 

WHAT ARE THE SIDE EFFECTS OF ANESTHESIA?

After eye surgery, especially after eye muscle surgery, children might feel sick to their stomach or throw up. Although these feelings may last for hours, it is not usually serious. It is important to keep the child calm and comfortable. Sometimes, medicine is helpful.

wu40B3KhSpewOak9sg8K__210_childanesthesia6.jpg

Fig. 4: Each hospital has its own rules about parents being with the child while they go to sleep in the operating room or wake up in the recovery room.

 

WHAT ARE THE RISKS OF ANESTHESIA?

Serious problems from anesthesia like brain damage or death, are extremely rare. Generally healthy children deal with anesthesia as well as adults.
 
It is best not to do eye surgery when the child is sick. Anesthesiologists and surgeons need to know all medical problems the child has and all medicines the child is taking. They need to know about any anesthesia problems the child or any relative has had in the past.
 
Some studies state that children under 4 years of age who have anesthesia may have higher risks of problems with learning and development, especially with many times under anesthesia. This finding is being looked at scientifically as doctors and scientists work to give safe anesthesia to young patients. Sometimes the risk of anesthesia in a young child may be worth it if the surgery is needed to help the child see and develop normally. 
 
Talk with your child’s doctors before surgery with general anesthesia to understand the risks and benefits. You can also read the SmartTots' article for more information.
 

CAN STRABISMUS/EYE MUSCLE SURGERY IN CHILDREN BE DONE WITH LOCAL ANESTHESIA OR NUMBING EYE DROPS?

In general, no. Unlike adult cataract surgery, using numbing eye drops on the eye is not enough anesthesia for eye muscle surgery. Only rarely, in very tough/brave teenagers and adults, strabismus surgery (eye muscle surgery) can be done with a local anesthesia injection numbing around the eye. 
 
Strabismus surgery can take 30 minutes to an hour or more and the patient must stay perfectly still so that there are no problems with surgery. Since most children can’t stay still for that long, especially with the stress of surgery, they usually need general anesthesia to stay safe and comfortable in eye muscle surgery.
 

SUMMARY

Anesthesia for children is generally safe. To limit problems from anesthesia, it is important to follow instructions about not eating or drinking before surgery. If the child is sick, surgery should wait until they are well, if possible. Talking with the anesthesiologist about the child’s medical and family history, as well as any other concerns will make sure anesthesia can be given safely.

 Updated 11/2023


#Conditions
Revised By: Marlo Russell Revised On: Nov 16, 2023 5:51 PM
Characters Edited: 254 Total: 14308
2. Anesthesia for Children Having Eye Surgery

Print Version

WHAT KINDS OF ANESTHESIA ARE THERE FOR CHILDREN HAVING EYE SURGERY?

 
There are two main types of anesthesia: local and general.
 
Local anesthesia numbs a specific area using medicine. Sometimes the medicine is injected with a needle or put on the area for surgery. For example, dentists use local anesthesia to operate on teeth. The person having surgery stays awake, can move and is aware of the procedure. 
 
General anesthesia puts the whole body to sleep. People cannot move, are not aware of what is happening, and do not feel pain during the surgery.
 
For eye surgery, especially in children, general anesthesia is often used to keep them safe and still. General anesthesia is also sometimes needed for a complete eye checkup for a child who is not able to do a full eye exam in the office. 
 
Sometimes, small eyelid procedures can be done under local anesthesia for older children who can stay still and calm.   
 

HOW IS ANESTHESIA GIVEN TO CHILDREN?

 
General anesthesia is usually given to children in two stages. First, a relaxing gas medicine is given through a face mask, causing the child to fall asleep. An intravenous (IV) line is usually placed in a vein of the arm or leg after a young child is asleep, this is to give other medicine for the surgery. Older children may have the IV line placed before going to sleep.
 
Sometimes, for short procedures, like opening a blocked tear duct, only the mask is used. But, for most eye procedures, a special breathing-tube called an endotracheal (ET) tube or laryngeal mask airway (LMA) is placed in the windpipe. This tube helps the doctors control the child’s breathing and give the anesthesia safely. Medicine through the tube and the IV keeps the child asleep for the surgery. The breathing tube is taken out at the end of surgery before the child is fully awake. The IV can be removed in the recovery area once the child is drinking well and feeling well. Figure 1 is a photo of an endotracheal tube.

Endotracheal Tube

Fig. 1: Endotracheal Tube

HOW IS ANESTHETIC “SLEEP” DIFFERENT FROM NORMAL SLEEP?

When a child is under anesthesia, it's different from regular sleep. The powerful medicines used affect the whole body. The anesthesiologist knows which medicines are best for the child and adjusts the medicines to keep the child comfortable and safe during surgery. 
 

HOW SHOULD YOU PREPARE A CHILD FOR SURGERY?

If your child is old enough to understand they are having surgery, it is important explain it to them so they feel comfortable. If the child is very young, staying calm and cheerful is helpful. Hospitals and surgery centers sometimes have services like Child Life to play and talk with children before surgery, making them feel more comfortable. Don't hesitate to share your questions or concerns. The staff, nurses, and doctors are there to make the surgery experience a positive one for your child. 
 

IS A MEDICAL EXAM NEEDED FOR CHILDREN BEFORE UNDERGOING GENERAL ANESTHESIA?

Yes. Before surgery a medical history and physical exam is needed to be sure the child is enough for the anesthesia and the surgery. This may be done by the child’s primary care physician, the anesthesiologist or the ophthalmologist.
 

DO ANESTHESIA PROBLEMS TEND TO RUN IN FAMILIES?

Yes, certain reactions to anesthesia can run in families. There are also medical problems that run in families that can cause problems with anesthesia. It is important to talk with your child’s anesthesiologist about any bad reactions to anesthesia that happened to your child or your child’s relatives. There are ways to handle problems from anesthesia, including medicines that can be given to help. It is important to share any concerns with your medical team so they can you’re your child safe during surgery. 
 

WHAT CAN A CHILD EAT OR DRINK BEFORE GENERAL ANESTHESIA?

Before surgery with general anesthesia, patients must not eat or drink for a certain time, usually 4-8 hours. The exact time depends on the patient's age and the type of food or drink. The hospital or surgery center will give specific instructions for your child.
 
It is important not to eat or drink before surgery because having a completely empty stomach helps avoid problems like aspiration. Aspiration is when whatever is in the stomach gets breathed into the lungs, and it can cause serious problems like pneumonia. Not eating or drinking can be hard for anyone, especially children, but it’s important for their safety. 
 
The hospital staff will tell you what time your child must stop eating and drinking. Please follow these instructions carefully to avoid delaying or canceling the procedure.
 

CAN A MEDICINE BE GIVEN TO CALM A CHILD BEFORE GOING INTO SURGERY?

For some surgeries, hospitals might give children a liquid medicine to calm the nerves and help with anxiety before the operation. This medicine can also help them forget the events right around the surgery but it may take the child longer to wake up from anesthesia. Please talk with your child’s anesthesiologist about what is best for your child’s surgery.
 

ISN’T GENERAL ANESTHESIA DANGEROUS?

No. Patients are closely watched by the anesthesiologist while they are asleep. Serious reactions to anesthesia are very rare. Every safeguard is taken to keep the child safe while they are asleep.

Teddy bear with Anesthesia Mask

Fig. 2: Parents can explain surgery to children who are old enough so that they understand why they are having surgery.

 

WHAT IS A LARYNGEAL MASK AIRWAY (LMA)?

A laryngeal mask airway (LMA) is a special breathing tube placed on top of the vocal cords but not going past them like the other breathing tube/endotracheal tube (ET). This can help lessen irritation in the windpipe during surgery and lessen sore throats afterward [see figure 3]. LMAs are not good breathing tubes for every surgery. Your ophthalmologist and anesthesiologist will decide which tube is right for your child’s surgery. 

Modern Anesthesia techniques often include special breathing tubes that reduce irritation to the windpipe during surgery.

Fig. 3: Newer forms of Anesthesia often use special breathing tubes that can lessen irritation to the windpipe during surgery.

 

CAN A PARENT BE WITH THE CHILD WHILE ANESTHESIA IS GIVEN?

Every hospital and surgery center has its own rules about parents being with their child when they go to sleep in the operating room or wake up in the recovery room. Please ask your ophthalmologist about the rules where they operate.
 

WHAT HAPPENS DURING THE RECOVERY FROM GENERAL ANESTHESIA AFTER SURGERY?

After surgery, the anesthesiologist helps the child wake up which might take a few or more minutes. When it is safe, the breathing tube is removed and the child breathes normally again. They are then moved to the recovery room. In the next hour or so, the child slowly wakes up. During this they might feel groggy, cranky or confused. The recovery room staff takes good care of the child, checking heart rate, blood pressure, pain level and breathing. 
 
In the next few hours the child will still be sleepy, a bit moody, and uncomfortable. The staff gives support and if needed, a mild pain medicine from the ophthalmologist or anesthesiologist. Most children can go back to their usual activities the next day. Sometimes, a child might sleep for hours after a surgery, especially after a long surgery or if they need extra pain medicine.
 

WHAT ARE THE SIDE EFFECTS OF ANESTHESIA?

After eye surgery, especially after eye muscle surgery, children might feel sick to their stomach or throw up. Although these feelings may last for hours, it is not usually serious. It is important to keep the child calm and comfortable. Sometimes, medicine is helpful.

wu40B3KhSpewOak9sg8K__210_childanesthesia6.jpg

Fig. 4: Each hospital has its own rules about parents being with the child while they go to sleep in the operating room or wake up in the recovery room.

 

WHAT ARE THE RISKS OF ANESTHESIA?

Serious problems from anesthesia like brain damage or death, are extremely rare. Generally healthy children deal with anesthesia as well as adults.
 
It is best not to do eye surgery when the child is sick. Anesthesiologists and surgeons need to know all medical problems the child has and all medicines the child is taking. They need to know about any anesthesia problems the child or any relative has had in the past.
 
Some studies state that children under 4 years of age who have anesthesia may have higher risks of problems with learning and development, especially with many times under anesthesia. This finding is being looked at scientifically as doctors and scientists work to give safe anesthesia to young patients. Sometimes the risk of anesthesia in a young child may be worth it if the surgery is needed to help the child see and develop normally. 
 
Talk with your child’s doctors before surgery with general anesthesia to understand the risks and benefits. You can also read the SmartTots' article for more information.
 

CAN STRABISMUS/EYE MUSCLE SURGERY IN CHILDREN BE DONE WITH LOCAL ANESTHESIA OR NUMBING EYE DROPS?

In general, no. Unlike adult cataract surgery, using numbing eye drops on the eye is not enough anesthesia for eye muscle surgery. Only rarely, in very tough/brave teenagers and adults, strabismus surgery (eye muscle surgery) can be done with a local anesthesia injection numbing around the eye. 
 
Strabismus surgery can take 30 minutes to an hour or more and the patient must stay perfectly still so that there are no problems with surgery. Since most children can’t stay still for that long, especially with the stress of surgery, they usually need general anesthesia to stay safe and comfortable in eye muscle surgery.
 

SUMMARY

Anesthesia for children is generally safe. To limit problems from anesthesia, it is important to follow instructions about not eating or drinking before surgery. If the child is sick, surgery should wait until they are well, if possible. Talking with the anesthesiologist about the child’s medical and family history, as well as any other concerns will make sure anesthesia can be given safely.

 Updated 11/2023


#Conditions
Revised By: Marlo Russell Revised On: Nov 16, 2023 5:46 PM
Characters Edited: -910 Total: 14054
1. Anesthesia for Children Having Eye Surgery

Print Version

WHAT KINDS OF ANESTHESIA ARE THERE FOR CHILDREN HAVING EYE SURGERY?

 
There are two main types of anesthesia: local and general.
 
Local anesthesia numbs a specific area using medicine. Sometimes the medicine is injected with a needle or put on the area for surgery. For example, dentists use local anesthesia to operate on teeth. The person having surgery stays awake, can move and is aware of the procedure. 
 
General anesthesia puts the whole body to sleep. People cannot move, are not aware of what is happening, and do not feel pain during the surgery.
 
For eye surgery, especially in children, general anesthesia is often used to keep them safe and still. General anesthesia is also sometimes needed for a complete eye checkup for a child who is not able to do a full eye exam in the office. 
 
Sometimes, small eyelid procedures can be done under local anesthesia for older children who can stay still and calm.   
 

HOW IS ANESTHESIA GIVEN TO CHILDREN?

 
General anesthesia is usually given to children in two stages. First, a relaxing gas medicine is given through a face mask, causing the child to fall asleep. An intravenous (IV) line is usually placed in a vein of the arm or leg after a young child is asleep, this is to give other medicine for the surgery. Older children may have the IV line placed before going to sleep.
 
Sometimes, for short procedures, like opening a blocked tear duct, only the mask is used. But, for most eye procedures, a special breathing-tube called an endotracheal (ET) tube or laryngeal mask airway (LMA) is placed in the windpipe. This tube helps the doctors control the child’s breathing and give the anesthesia safely. Medicine through the tube and the IV keeps the child asleep for the surgery. The breathing tube is taken out at the end of surgery before the child is fully awake. The IV can be removed in the recovery area once the child is drinking well and feeling well. Figure 1 is a photo of an endotracheal tube.

Endotracheal Tube

Fig. 1: Endotracheal Tube

HOW IS ANESTHETIC “SLEEP” DIFFERENT FROM NORMAL SLEEP?

Anesthetic “sleep” is quite different from normal sleep because the potent medications affect every organ of the body. Achieving and maintaining the desired effect requires continuous monitoring and adjustment. Your anesthesiologist has the experience and knowledge to decide which agents are best for your child and to administer them in a safe manner.

HOW SHOULD YOU PREPARE A CHILD FOR SURGERY?

If your child is old enough to understand why he or she is having the surgery, it is important to provide an explanation so that they are comfortable with the decision. If the child is very young, then being calm and cheerful for them is helpful. Your hospital may provide services such as Child Life to help with this process by playing with and talking to the child before the surgery. If you have any questions please ask any member of the hospital team. The staff, nurses, and doctors will try to make the hospital experience a positive one.

IS A MEDICAL EXAMINATION NEEDED FOR CHILDREN BEFORE UNDERGOING GENERAL ANESTHESIA?

Yes. Before surgery a medical history and physical examination is performed to be sure your child is sufficiently healthy to undergo anesthesia and to have any planned surgery. This may  be done by the child’s primary care physician, or the anesthesiologist as well as the ophthalmologist.

DO ANESTHESIA COMPLICATIONS TEND TO RUN IN FAMILIES?

Yes, there are certain reactions to anesthesia that run in families, as well as hereditary medical conditions that can make administering anesthesia more complex. Be sure to speak with your child’s anesthesiologist regarding any known adverse reactions to anesthesia that have occurred in your child’s blood relatives. These complications can be severe such as malignant hyperthermia or less severe, but still uncomfortable, like nausea and vomiting. There are steps that can be taken and/or medications which can be given to help with these potential complications. 

WHAT CAN A CHILD EAT OR DRINK PRIOR TO GENERAL ANESTHESIA?

Patients undergoing general anesthesia should not eat or drink anything for a certain amount of time before a surgery is performed. This period of time may be 4-8 hours, depending on the age of the patient and the type of food or liquid. The specific requirements for your child will be given to you directly by the hospital.   

Having a completely empty stomach helps avoid pulmonary aspiration. Pulmonary aspiration occurs when stomach contents are breathed into the lungs and can cause serious complications such as pneumonia. Fasting can be difficult for anyone, especially children, but please remember it is done for the child’s safety. 

The hospital staff will give you specific instructions about what time your child must stop eating and drinking. Please follow them exactly as advised to avoid delay or cancellation of the procedure.

CAN A SEDATIVE BE GIVEN TO CALM A CHILD BEFORE GOING INTO SURGERY?

Depending on the surgery your child is having, this may be done. Many hospitals will give a liquid sedative to children prior to surgery to help ease any apprehension. A sedative comforts children as they await their surgery, reduces anxiety as they move into the operating room, and helps them forget the events immediately associated with their surgery.  A sedative may, however, lengthen the time it takes to emerge from aneshthesia.  Please discuss the options with your child’s anesthesiologist prior to surgery.

ISN’T GENERAL ANESTHESIA DANGEROUS?

No. Patients are extensively monitored by the anesthesiologist while they are asleep. Serious reactions to anesthesia are extremely rare. All precautions are taken to ensure the child’s safety while he or she is asleep.

Teddy bear with Anesthesia Mask

Fig. 2: Parents should tell children old enough to understand why they are having surgery.

WHAT IS A LARYNGEAL MASK AIRWAY?

A laryngeal mask airway (LMA) is a special breathing tube which is positioned on top of the vocal cords instead of going past them as an endotracheal tube does. This may reduce irritation to the windpipe during surgery and lessen sore throats afterward [see figure 3]. LMAs are not appropriate in every case. Your ophthalmologist and anesthesiologist will decide if it is right for your child and for the surgery being performed. 

Modern Anesthesia techniques often include special breathing tubes that reduce irritation to the windpipe during surgery.

Fig. 3: Modern Anesthesia techniques often include special breathing tubes that reduce irritation to the windpipe during surgery.

CAN A PARENT BE WITH THE CHILD WHILE ANESTHESIA IS GIVEN?

Each hospital will have its own policies about parents being with the child during the time the child is going to sleep in the operating room or waking up in the recovery room. Ask your doctor about specific policies at your hospital.

WHAT HAPPENS DURING THE RECOVERY FROM GENERAL ANESTHESIA AFTER SURGERY?

Once the surgery is complete, the anesthesiologist will begin to wake up the patient. This may take several minutes or longer.  Once it is safe to do so, the tube is removed and normal breathing resumes. The child is then transferred from the operating room to the recovery room. Over the next hour or so, the child will gradually wake up. During this time children are often groggy, irritable and confused. They will receive constant supportive care and reassurance from the recovery room staff, who are also monitoring the child’s heart rate, blood pressure, pain level and breathing. During the next few hours the child will still be sleepy, sometimes cranky, and may have a lowered tolerance for discomfort or pain. Additional reassurance and the use of mild pain medications are helpful when needed. Most children are back to many normal activities by the next day. Occasionally a child will sleep for hours after a procedure, especially after a long surgery or if sedating pain medications are required.

WHAT ARE THE SIDE EFFECTS OF ANESTHESIA?

Children may be nauseated or vomit after eye surgery, particularly muscle surgery. Although the nausea may last for hours, it is rarely serious. Everything possible should be done to reassure the child and make him or her comfortable. Medication is sometimes helpful.

wu40B3KhSpewOak9sg8K__210_childanesthesia6.jpg

Fig. 4: Each hospital will have its own policies about parents being with the child during the time the child is going to sleep in the operating room or waking up in the recovery room.

WHAT ARE THE RISKS OF ANESTHESIA?

Serious anesthesia complications, such as brain damage or death, are exceptionally rare. Generally healthy children tolerate anesthesia at least as well as adults.

Whenever possible, elective eye surgery should be avoided when the child is ill. Anesthesiologists and surgeons should be informed of all medical conditions and all medications the child is taking. They should also be informed of any anesthetic problems the child or any blood relative has experienced, as there are some rare hereditary conditions, which are associated with a greater risk.

Some studies have suggested that children under 4 years of age who receive anesthesia may be at an increased risk of long term neurodevelopmental effects and/or learning disabilities, particularly after multiple anesthetic sessions This is currently an active area of research as physicians and scientists work to learn more about how to most safely provide anesthesia to the youngest patients. These risks may be outweighed by the benefits of a medically necessary procedure. When a surgery is needed to improve a child’s development, or vision, it is not advisable to delay it until after four years of age. Talk with your child’s physician prior to surgery about the risks and benefits of surgery or an examination which requires general anesthesia. You can also read SmartTots' article for further information.

Although eye surgery is usually quite routine, children are extensively monitored by the anesthesiologist while they are asleep. Serious reactions to anesthesia are extremely rare. All precautions are taken to ensure children’s safety while they are asleep.  Please discuss all your questions with your child’s anesthesiologist prior to surgery.

CAN STRABISMUS SURGERY IN PEDIATRIC PATIENTS BE DONE WITH TOPICAL OR LOCAL ANESTHESIA?

Generally, no. Rarely, in a select group of exceptionally stoic teenagers and adults, strabismus surgery can be done with a local anesthetic injection through the lower eyelid to numb the nerves around the eyeball. Unlike its use in adult cataract surgery, topical anesthesia, consisting of numbing eye drops to the surface of the eye, does not provide sufficient patient comfort to be used during eye muscle surgery. Strabismus surgery typically requires 30 minutes and often significantly longer. The patient must be completely still and comfortable during this period to avoid potentially serious complications that may result from sudden unexpected movements. As most children cannot be expected to remain still for the time necessary to complete the surgery, nearly all children require general anesthesia in order for eye muscle surgery to be performed safely and comfortably.

SUMMARY

Anesthesia for children is generally safe. Complications may be minimized by avoiding food and drink as directed before general anesthesia and postponing elective surgery if the child is ill. Modern anesthesia allows surgery or examinations to be performed without pain or anxiety.

Updated 4/2021


#Conditions
Revised By: Marlo Russell Revised On: Nov 16, 2023 5:38 PM
Characters Edited: 0 Total: 14964