Preparing your child for anesthesia

The pediatric specialists and family-friendly environment at Children’s Health℠ will help make your child’s procedure as comfortable as possible. As a parent, you also have an important role in preparing your child for anesthesia. Help us give your child the best possible care by following these guidelines and instructions, unless advised otherwise by your anesthesiologist, to avoid the cancellation of your procedure.

How to best prepare your child for general anesthesia

Your child’s doctor will provide detailed instructions for how to prepare your child for anesthesia. Their recommendations will include:

Fasting guidelines

Your child will need to stop eating and drinking certain foods and liquids before their anesthesia appointment. This is to prevent your child from throwing up when they are under anesthesia.

  • More than eight hours before arrival: If your child was prescribed a bowel preparation for a procedure, please follow your doctor’s instructions carefully.
  • Starting eight hours before arrival: No solid high-fat food, fried food, meat (protein), cheese, non-clear liquids, cow’s milk, gelatin (Jell-O®), chewing gum, or candy
  • Starting six hours before arrival: No solid low-fat food, formula, liquid thickeners, breast milk with thickeners, infant formulas, yogurt, cereals, bread, fruit, fruit juice with pulp (orange juice), carbohydrates or toothbrushing
  • Starting four hours before arrival: No pure breast milk (without thickeners or cereal)
  • Starting two hours before arrival: No clear liquids (water, Pedialyte®, apple juice, Gatorade®, clear sodas, coffee or tea without dairy, energy drinks, Popsicles®)

Note: Please contact your pediatric anesthesiologist for specific fasting instructions if your child has nutritional requirements due to severe undernutrition.

Prescription medication guidelines

  • Medications: Take as prescribed with a sip of water at least two hours before the scheduled procedure, unless otherwise directed
  • Medications taken in foods (e.g. apple sauce) or any other non-clear liquid medication (e.g. antibiotic): Take six hours before a scheduled procedure
  • Inhalers and nebulizers: Begin treatment two days before the procedure, even if they don't have symptoms. (If your child’s surgery has been canceled before due to wheezing, it is recommended that you consult your pediatrician and consider a dose of steroids a few days before their surgery.)
  • Ibuprofen (Motrin®, Advil™): Stop taking two days before the procedure. Acetaminophen (Tylenol®) is allowed.
  • Herbal medications and diet drugs: Stop taking one week before the procedure
  • Diabetics on insulin: Consult with their treating physician

Does your child have symptoms of wheezing (bronchospasm)?

Most children with asthma complain more often about chest tightness (in combination with shortness of breath or cough) than wheezing. If your child has chronic or episodic respiratory symptoms, asthma or another chronic airway disease, please consult their primary care physician a few days before their procedure.

Anesthesia preparation: What to bring before surgery

To make your child as comfortable, we recommend you bring the following:

  • Clothing: Comfortable, loose-fitting clothing without metal or zippers, such as a short sleeve shirt and slip-on shoes. Avoid one-piece outfits on children.
  • Comfort and warmth: Pack a favorite stuffed animal, toy or book to comfort your child. Bring a blanket to keep your child warm.
  • Bedwetting: Your child may benefit from wearing a pull-up diaper, if they wear one while sleeping. Bring an extra set of clothes for children who are at risk for bedwetting. For infants, bring a small supply of diapers and bottles.
  • Go to bed early: Some of the best advice is for your child or teenager to get a good night’s sleep, so they are well-rested on the day of their procedure.

Talking to your child about anesthesia

Prepare your child and yourself for what will happen at the hospital. This can help make your child’s surgery day as comfortable as possible. Things you can do to help include:

  • Recognize your child’s fears and concerns.
  • Describe what your child may see, feel, taste and hear. Avoid explaining procedures that may happen under anesthesia.
  • Be honest and explain in a language your child can understand.
  • Point out that this is temporary. This is not a punishment for bad behavior.

To help give your child undivided attention during their hospital visit, we recommend that you arrange for siblings younger than 12 to stay with family or friends.

After anesthesia

You may have heard of or have experienced a child waking up “wild” from anesthesia. It is not unusual to see children wake up from anesthesia with delirium and agitation. Known as pediatric anesthesia emergence delirium, it is most often seen in preschool-aged children, and boys are more affected than girls. The delirium occurs around 15 minutes after a general gas anesthetic and usually ends within 30 minutes. Symptoms can include:

  • Lack of eye contact
  • Kicking
  • Head tilting
  • Holding their head backward
  • Inconsolability
  • Pulling out IV catheters and dressings

A note for parents

Please have a nourishing breakfast out of the sight of your children and before arriving at Children’s Health. Dizziness, lightheadedness and fainting have occurred in parents who have not prepared physically and emotionally for their child’s day of surgery.

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