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Waking after anesthesia

Reducing anxiety before a child’s surgery: Pediatric anesthesiologists available for interviews

Each year about a million children under the age of four in the United States have surgery with general anesthesia, leaving millions of parents worried about how to prepare their families. Much of that worry centers on the anesthesia aspect of the surgery.

Reducing parental anxiety has been shown to decrease children's anxiety and have positive implications for a child’s short and long-term recovery. Members of Yale New Haven Children’s Hospital’s (YNHCH) Anesthesiology team tackle some of the most important topics around reducing anxiety when a child is undergoing a procedure.

Know your team

There is a difference between a pediatric anesthesiologist and an adult anesthesiologist.

“Having a pediatric anesthesiologist on your surgical team ensures your child is getting care from someone with highly specialized training regarding best practices for children,” said Cheryl Gooden, MD, pediatric anesthesiologist, YNHCH.

Dr. Gooden has traveled around the world to serve as an anesthesiologist on children’s craniofacial and ophthalmology humanitarian missions and emphasizes that “kids are physiologically different from adults and their needs are best met by someone who has expertise in managing different developmental ages.”

Ask questions

“I encourage parents to write down their questions,” said David Waisel, MD, chief, Pediatric Anesthesiology Section and medical director, YNHCH Operating Room, whose research focuses on compassionate behavior in medicine. "On the day of surgery many parents are appropriately distracted; having a checklist of questions to go through can ease the burden of remembering them on the spot.”

Involve children in the conversation

“Sometimes kids hear stories from friends about anesthesia and we welcome them to bring all of their concerns to us,” said Heidi Boules, MD, medical director, Pediatric Cardiac Anesthesia, Yale New Haven Children’s Hospital.

Dr. Boules said children might ask, Are you going to knock me out? “We don’t knock anyone out,” said Dr. Boules. “It is a gentle process of falling to sleep, whether by breathing the anesthesia or other means.”

Older kids tend to be worried about waking up during the operation.

“I tell them there is nothing to worry about,” said Dr. Waisel. “I also remind them that we are there the entire time monitoring every aspect of their health to ensure immediate, personalized, care.”

Talk to younger kids

Marianne Sparan, certified child life specialist, Yale New Haven Children’s Hospital, who provides education and support for patients and families, recommends being honest with your child while keeping in mind their developmental age.

“Children often find it helpful to have each step laid out for them in a concrete manner. For example, we might say something like, ‘Tomorrow we are going to the hospital. We will meet sleep doctors who will give you special medicine to help you rest. Then the dentist will fix your teeth while you are sleeping. When the dentist is done you will wake up and we will go home.”

Ms. Sparan also recommends bringing a child’s favorite toy, comfort item and preferred sippy cup. These familiar items have been shown to reduce anxiety.

Recovery

“Parents often want to engage their child immediately, but children do better when they can rest as long as they need,” said Dr. Gooden.

Dr. Gooden, who specializes in difficult airways and children with syndromes, cautions that occasionally children will wake up crankier than usual, but this is a temporary situation.

“From our perspective, we are focused on getting a child to the other side of surgery as comfortably as possible, so parents should not feel rushed to leave the hospital.”