Why do children need anesthesia?
In pediatric urology, most operations and some tests are done under general anesthesia. During surgery, the child must stay still and must not feel pain or fear. In young children, this is not possible with local anesthesia alone.
Anesthesia is given by a pediatric anesthesiologist, who continuously monitors the child’s breathing, heart rate, blood pressure and oxygen level throughout the operation.
Safety
Modern pediatric anesthesia is very safe. In healthy children having planned surgery, serious complications are extremely rare.
Fasting rules
Fasting is needed so that food in the stomach does not get into the airways during anesthesia. General rules:
| What | How long before anesthesia to stop |
|---|---|
| Solid food, cow’s milk, formula | 6 hours |
| Breast milk | 4 hours |
| Water, clear drinks without pulp | 2 hours |
These rules are general. The anesthesiologist will tell you the exact times for your child. Keeping a child hungry and thirsty longer than needed is also harmful: the child becomes irritable and dehydrated.
How to prepare your child
- Young children: bring a favorite toy or pacifier. Stay calm; children sense a parent’s worry.
- Preschoolers: explain the day before in simple words: “The doctors will give you sleepy medicine, you will fall asleep, and when you wake up I will be right there.”
- School-age children and teenagers: answer their questions honestly, and do not mislead them.
After waking up
- For the first 30–60 minutes, the child may be sleepy, sometimes irritable, and may cry. This is a normal part of waking up from anesthesia.
- Once the child is fully awake, water is given first, then light food.
- Sometimes there may be nausea or vomiting once.
- The child may be tired that day and is usually back to normal the next day.
More: care at home after surgery.
Note for pediatricians and family doctors
Clear fluids may be given up to 2 hours before anesthesia; prolonged fasting increases the risk of dehydration and hypoglycemia. Randomized studies (GAS, PANDA) have not shown a long-term negative effect of a short, single anesthetic on a child's neurodevelopment.
What happens at the visit?
- Before surgery, the anesthesiologist examines the child and asks about illnesses, allergies and medicines.
- Fasting times are given in writing.
- On the day of surgery, a parent stays with the child, and the child is not left alone until anesthesia begins.
Frequently asked questions
Does anesthesia harm a child's brain?
Large studies have shown that a short, single anesthetic at a young age does not harm a child's development or ability to learn. Putting off surgery unnecessarily often carries a greater risk.
My child has a cold. Should the surgery be postponed?
With a mild runny nose, surgery can often go ahead. With fever, cough or wheezing, it is usually postponed for 2–4 weeks. The anesthesiologist makes the decision, so let us know the day before surgery.
Can a parent come into the operating room?
In many cases, a parent can stay with the child until the child falls asleep. This depends on the hospital's rules, so ask in advance.
Related topics
- Care after surgeryWound care, bathing, pain relief, activityOperation
- CircumcisionCircumcision surgery, cosmetic circumcisionOperation
- OrchiopexyUndescended testicle surgery, laparoscopic orchiopexyOperation
- Inguinal hernia surgeryHerniotomy, laparoscopic hernia surgeryOperation
- Hypospadias surgeryHypospadias repair, urethroplastyOperation
Sources
- Frykholm P et al. Pre-operative fasting in children: a guideline from the European Society of Anaesthesiology and Intensive Care. Eur J Anaesthesiol, 2022.
- McCann ME et al. Neurodevelopmental outcome at 5 years of age after general anaesthesia or awake-regional anaesthesia in infancy (GAS). Lancet, 2019.
This page is for education. Decisions about your child’s treatment are made together with the doctor after an examination.