Anesthesia

What Is Anesthesia?

Anesthesia is the use of medicine to prevent discomfort during surgery or medical procedures. Most people do well with anesthesia (an-ess-THEE-zhuh) and have no problems afterward.

How Does Anesthesia Work?

Anesthesia works by blocking signals in the nervous system. The nervous system is made up of the brain, spinal cord, and nerves. Messages from the body travel through the nerves and spinal cord to the brain. Anesthesia blocks pain messages from getting to the brain.

What Are the Different Types of Anesthesia?

There are three types of anesthesia: general, regional, and local. Sometimes, a patient gets more than one type of anesthesia. The type(s) of anesthesia used depends on the surgery or procedure being done and the age and medical conditions of the patient.

General anesthesia: A patient who gets general anesthesia is completely unconscious (or "asleep"). They can’t feel any pain, are not aware of the surgery as it happens, and don’t remember anything from when they are “asleep.” Patients can get general anesthesia through an IV (into a vein) or inhale it through their nose and mouth. A tube placed in their throat helps the person breathe while they are under general anesthesia. 

Regional anesthesia: This type of anesthesia is injected near a cluster of nerves in the spine. This makes a large area of the body numb and unable to feel pain. Common types of regional anesthesia include epidurals (often used in childbirth), spinal blocks, and peripheral nerve blocks (when the medicine is injected near a nerve or group of nerves to block feelings of pain in a specific area of the body).

Local anesthesia: Local anesthesia numbs a small part of the body (for example, a hand or patch of skin). It can be given as a shot, spray, or ointment. It may be used for dental work, stitches, or to lessen the pain of getting a needle.

How Is Anesthesia Given?

Before they give a child anesthesia, doctors and nurses will work with the child and their parents to ease any fears. Sometimes, a child gets sedation before the IV is placed or anesthesia is given. This medicine, given by mouth or as a nasal spray, helps them relax and feel sleepy. A parent or caregiver usually can stay with the child until the sedative starts to work.

Then, the child gets the anesthesia from either an anesthesiologist or a CRNA (certified registered nurse anesthetist). Depending on the anesthesia type, it may be given through a mask, breathing tube, or IV.

During anesthesia, the doctor or nurse will closely watch breathing, heart rate and rhythm, body temperature, blood pressure, and blood oxygen levels.

After general anesthesia, kids go to the post-anesthesia care unit (PACU) or recovery room. Parents or caregivers usually can join their child here and be with them while they wake up. Kids often go home the same day, but some stay in the hospital.

What Are the Side Effects of Anesthesia?

For regional and local anesthesia, someone may feel sore where the needle was given. 

For general anesthesia, someone may feel groggy and a little confused when waking up after surgery. Other common side effects can include nausea or vomiting, chills or shakiness, or a dry throat (from the breathing tube).

These side effects usually aren’t dangerous and go away quickly.

What Are the Risks of Anesthesia?

For most people, anesthesia is very safe. In very rare cases, anesthesia can lead to problems such as abnormal heart rhythms, breathing problems, allergic reactions to the medicines used, and even death. The risks depend on the kind of surgery or procedure, the condition of the patient, and the type of anesthesia used. 

Researchers are studying whether anesthesia and sedation can affect the brain development of young children. Most likely, getting anesthesia or sedation for a short time for one surgery or procedure does not put a child at risk. Parents should talk to their health care provider about possible risks for their child.

How Can Parents Help?

Most children don’t have any problems with anesthesia.

Before your child gets anesthesia, the doctors and nurses will ask you about:

• your child's current and past health, including any breathing problems like asthma and whether your child snores
• any medicines (prescription and over-the-counter), supplements, or herbal remedies your child takes
• any allergies (especially to medicines, foods, or latex) your child has
• whether your child smokes, drinks alcohol, or uses any drugs
• any past reactions your child or any family member has had to anesthesia

Follow the doctor's and nurse’s recommendations about what to do before anesthesia, such as:

• when your child needs to stop eating or drinking
• whether your child needs to stop any medicines or herbal supplements before surgery

If your child has cold symptoms (a cough and/or runny nose) or breathing problem in the days before the surgery, it is very important to let the doctor and care team know.