🧸 Pediatric Anesthesia: What Parents Need to Know

For children under the age of 11, we often begin anesthesia using a mask induction, rather than starting with an IV (a needle in the vein). For kids 11 and older, we usually try to place an IV before surgery, if possible.

😴 What Is a Mask Induction?

Mask induction is a gentle way to help your child fall asleep for surgery.

  • Your child will breathe through a soft mask that delivers medicine to help them fall asleep.

  • It’s painless and usually takes less than a minute.

Most young children fall asleep calmly and smoothly with this method.

✂️ What Happens Next?

After your child is asleep under general anesthesia (GA), what happens depends on the type of surgery:

For Short Procedures (like ear tubes or some circumcisions):

  • We may not need to place an IV at all.

  • The procedure is quick, and your child stays asleep with anesthesia given through the mask.

For Longer or More Involved Surgeries:

  • We place an IV after your child is asleep—they won’t feel a thing.

  • Through the IV, we give:

    • Pain medication

    • Anti-nausea medicine

    • IV fluids

    • Antibiotics, if needed for the type of surgery

  • After the IV is in place, we place a breathing device:

    • Either a laryngeal mask airway (LMA) or an endotracheal tube, depending on the surgery and your child’s needs.

We carefully monitor your child’s breathing and comfort the entire time.

🦷 If Your Child Is Having Dental Surgery

For dental procedures, we often use a technique called nasal tracheal intubation, where the breathing tube goes through the nose instead of the mouth. This allows the dentist to work freely while keeping your child safely asleep and comfortable.

🍼 Eating and Drinking Before Surgery (NPO Guidelines)

To keep your child safe during anesthesia, it’s very important to follow the ASA (American Society of Anesthesiologists) guidelines for when to stop eating and drinking before surgery. These rules help prevent stomach contents from being inhaled into the lungs while under anesthesia.

Here are the general guidelines:

  • Solid foods: Stop 8 hours before surgery
    (includes crackers, cereal, meat, pasta, candy, etc.)

  • Infant formula: Stop 6 hours before surgery

  • Breast milk: Stop 4 hours before surgery

  • Clear liquids: Okay up to 2 hours before surgery
    (includes water, apple juice, Pedialyte, plain Jell-O—no milk or pulp)

Note: "Clear liquids" means liquids you can see through. Avoid anything with milk, dairy, or solid particles.

Your care team will give you exact instructions based on your child’s surgery time—please follow them carefully to avoid delays or cancellations.

🛁 For Urologic Surgeries: Caudal Analgesia for Pain Relief

For certain urologic procedures (like circumcision, hernia repairs, or other surgeries involving the lower abdomen or groin), we may provide additional pain relief using a technique called caudal analgesia.

What is Caudal Analgesia?

  • After your child is asleep, we may place a small injection of local anesthetic into the caudal space—an area near the tailbone at the base of the spine.

  • This technique numbs the lower part of the body, helping to reduce pain both during and after surgery.

  • It’s often used alongside general anesthesia, so your child is completely unaware it's being done.

Benefits of Caudal Analgesia:

  • Provides excellent pain relief without the need for strong opioids

  • May reduce the need for IV pain medicine after surgery

  • Can lead to smoother recovery and easier wake-ups

Are There Risks?

Caudal analgesia is very safe, but potential risks include:

  • Bruising or soreness at the injection site

  • Temporary numbness or weakness in the legs

  • Rarely, infection or bleeding

  • In extremely rare cases, nerve irritation

Your CRNA or anesthesia provider will talk with you ahead of time if a caudal block is planned and answer any questions you may have.

👩‍⚕️ We're with Your Child Every Step of the Way

Your nurse anesthesiologist stays with your child throughout the entire procedure, constantly monitoring their:

  • Breathing

  • Heart rate

  • Blood pressure

  • Comfort level

Once surgery is done:

  • We carefully wake your child up in the operating room with us.

  • Then we bring them to the recovery area, where our specially trained nurses will continue to monitor them.

  • Once your child is awake enough, they’ll be reunited with you.

It’s normal for children to be confused, clingy, or tearful when they first wake up. This is a temporary and expected reaction to anesthesia. A few hugs from mom or dad usually helps them calm down quickly.

⚠️ Are There Any Risks?

Pediatric anesthesia is very safe, especially with today’s advanced monitoring and medications. However, as with any medical procedure, there are some possible risks, including:

  • Mild nausea or vomiting

  • Sore throat (if a breathing tube is used)

  • Bruising or soreness at the IV site

  • Rarely, breathing or heart rhythm changes (closely monitored and treated immediately)

  • Allergic reactions to medications (extremely rare)

Your child’s safety is our top priority. Our team will do everything we can to ensure a smooth, comfortable, and safe experience for your family.

Your anesthesia awaits.