Preparing Your Child for Surgery
Preparing for your child's surgery can be challenging! The experience affects you, your child, and your family. Our pediatric anesthesiology team is there to support you, and is dedicated to the special care of children before, during, and after surgery and anesthesia.
Whether this is your child's first surgery, or the family has been here before, we will be with you through the process of having surgery or any procedure requiring anesthesia at UCLA Mattel Children’s Hospital.
On this page, you will find information about:
- The pre-anesthesia evaluation visit
- Talking to your child about surgery
- How do I prepare my other children?
- The day before surgery
- When to stop eating and drinking
- Taking other medications before surgery
- What to expect when you arrive
- Our anesthesia team
- Types of anesthesia
- Waking from anesthesia
- How illness can affect anesthesia
If your child's surgeon has requested a pre-anesthesia evaluation, you will need to visit our Preoperative Evaluation and Preparation Clinic (PEPC). Please call 310-794-4494 to schedule an appointment at least two weeks before your child's scheduled surgery date.
Your surgeon will only require this visit for patients who have complex medical issues or have increased anesthesia risk. If you have specific concerns about anesthesia and believe your child should be seen in the PEPC, please ask your child’s doctor to make a referral. You can also email the pediatric anesthesiology team directly with any questions: UCLAPedsAnes@mednet.ucla.edu.
The PEPC visit will include a complete medical history evaluation and a physical exam. If your child's previous health care has been outside of UCLA Health, and you have any of the medical records, please bring those with you when you come. If you have questions about what information to bring, please call 310-794-4494.
Parents want to protect their children. However, being secretive about an upcoming procedure can cause more anxiety for a child. Here are a few tips from our Child Life Specialists:
Appear confident. Your child looks to you to know how to feel. If your face looks worried, your child will worry. It's easy to let our own fears induce fear in our children. Learn as much as you can about the procedure that is planned, and then talk naturally to your child just as you would about any other upcoming event that might be stressful, such as starting at a new school.
Be truthful. It is important to be honest. If you lie to a child about coming to the hospital, it can create mistrust. Offer simple explanations (especially for younger children) about procedures and anesthesia, such as, "The doctors will help you sleep with medicine."
Follow your child's lead. Do not force the discussion if your child is resistant. However, be ready to talk about it if your child suddenly brings it up, perhaps while playing or riding in the car. You know your child best.
Ask your child questions. Asking your child questions is a good way to find out how you can help. Considering your child's age, temperament and any previous experience with surgery or hospitals, you might ask questions such as:
- Do you have questions about who will be with you at the hospital or how long you will stay there?
- Is there a part you’re worried about? Could we do something to make it easier?
- Is there anything you’re looking forward to about being in the hospital?
Talk to older children sooner rather than later. The older children are, the more time they need to process. Start talking to teenagers a few weeks before the surgery. For preschoolers, wait until a few days before.
Surgery is challenging for the entire family. It can affect siblings' routines and how available you are for them. It is not uncommon for siblings to have some regression or begin acting out to get attention when their brother or sister is in the hospital. Child Life Specialists are available through our Chase Child Life Program to support siblings.
The day before your child's surgery is the time to make sure all plans are in order. It can feel overwhelming, especially if having surgery is a new experience. Make sure that you have the support you need. Consider asking a family member or friend to help on this day.
Your child's doctor may have instructions specific to your child's surgery or procedure. It is important to follow these instructions. Make sure to ask questions if anything is confusing. On the day of the procedure, you will have the opportunity to meet your child’s physician anesthesiologist and have all your questions about anesthesia answered. Often, the anesthesiologist will call you the night before.
Rules about when to stop eating and drinking are in place to keep your child safe!
Children over the age of 3 may eat and drink until 8 hours before their scheduled surgery time. They may continue to drink clear liquids — NOT milk or dairy products — until 2 hours before. Clear, see-through liquids include:
- clear fruit juices such as apple juice and white cranberry juice
- clear, electrolyte-replenishing drinks such as Pedialyte, Gatorade or Powerade (NOT yogurt or pulp-containing "smoothies")
Toddlers between 6 months and 3 years of age may eat and drink until 8 hours before their scheduled surgery time. They may have breast milk or formula up to 6 hours before. They may continue to drink water, apple juice, or Pedialyte until 2 hours before.
Babies under the age of 6 months may have breast milk or formula up to 4 hours before their scheduled surgery time. They may continue to drink water, apple juice, or Pedialyte until 2 hours before.
Certain procedures may require special preoperative fasting instructions. If you receive additional or different instructions from your surgeon or the physician performing your child's procedure, please follow those carefully.
Please check with your child's doctor about whether your child should take any of his or her usual medications on the morning of surgery.
Meet the team: You will meet the members of your child's surgical and anesthesia team. Feel free to ask the surgeon any questions you may still have about the surgery. You will have a chance to review the anesthesia plan with your child's pediatric anesthesiologist.
Child Life Specialist: For procedures in the main hospital, a Child Life Specialist is usually available. They help children cope with hospitalization, often using play and tablet computers, and are experts at explaining what is happening in child-friendly terms: "There will be a lot of bright lights and equipment, and the doctors and nurses will be wearing masks and long gowns."
Sedation: The anesthesiologist may give your child a sedative, or relaxing medicine. This can make the child act silly and become sleepy. After taking it, your child should remain in bed.
Waiting: You will stay with your child while waiting to go to the operating room or procedure room.
Transfer: One of our team members will bring your child to the operating room. Parents usually do not accompany their child, though in certain situations parents may be allowed to be with their child in the operating room while anesthesia is started. Your team will discuss this with you. Your Child Life Specialist can also help with transferring your child from the preoperative area to the operating room. This is particularly helpful for special-needs children.
In the OR: Your child will receive anesthesia. The Child Life Specialist is available to stay in the OR while your child receives anesthesia, if this is part of the plan that you and the team create.
Our team includes expert physician anesthesiologists, residents, fellows, and nurse anesthetists, who have special training and interest in pediatric anesthesia. Together, they form an integral part of your child's Pediatric Perioperative Surgical Home team, and will work with you to develop the right anesthesia plan for your child.
Your child's physician anesthesiologist will determine the safest and most effective type of anesthesia based on the type of surgery, your child’s age, and your child's medical condition. He or she will discuss the risks of anesthesia with you. We encourage you to ask any questions.
The different types of anesthesia we may use include:
Local anesthesia: We use local anesthesia to numb a small area so that your child does not feel pain there. A local anesthetic cream may be used to numb the hand or arm before drawing blood or starting an IV. With local anesthesia, the child remains conscious. Often, we combine a local anesthetic with other types of anesthesia for pain management.
Regional anesthesia: We use regional anesthesia to numb an entire area of the body so that your child does not feel pain anywhere in that area. An epidural is an example of regional anesthesia. If used alone, your child would remain conscious. However, most children receive general anesthesia in addition to regional, since typically it is very difficult for children to remain still for the entire length of the surgery or procedure.
General anesthesia: With general anesthesia, your child remains asleep and pain-free for the whole surgery. Your child will inhale the anesthesia through a breathing mask. For older children, we may give it through an intravenous (IV) line that puts the medicine directly into the vein. Sometimes we place a breathing tube after your child is asleep to help your child breathe safely during surgery. When the surgery is over, anesthesia stops. As the medications wear off, your child will gradually wake up.
We will let you know as soon as your child's surgery is complete. Someone from the surgery team will tell you about the procedure and answer your questions.
Each child wakes up from anesthesia differently. Some become wide awake in the recovery room. Others may be groggy for a longer time. It may take children one to two hours to wake up fully from anesthesia. We will contact you as soon as possible to reunite you with your child, either in the recovery room, known as the post-anesthesia care unit (PACU), or the intensive care unit (ICU), depending on the type of surgery.
About one-third of all children experience confusion or excitement, known as "emergence delirium," as they wake from anesthesia. Emergence delirium is a common reaction that can happen to any child, especially those younger than 6 years old. It may cause children to cry inconsolably, and sometimes even to scream, roll around, or kick. This may be upsetting to parents, who assume their child is in pain.
Important things to remember about emergence delirium:
- It does not mean your child is in pain.
- It will go away on its own.
- Your child will not remember it.
Members of the anesthesia team will be there in the PACU or ICU with you, and will help you and your child through any excitement or fearfulness during the waking-up period. The best role for you as a parent or guardian is to stay calm and comfort your child.
Sometimes even minor illness, such as a cough, runny nose, or fever, can cause problems during surgery and anesthesia. If this is the case, your anesthesiologist may decide to postpone surgery. Before surgery, let your surgeon’s office know immediately if your child:
- Has been exposed to infectious diseases such as measles, mumps or chicken pox
- Had a fever, cough, runny nose, sore throat, nausea, or diarrhea in the two weeks before surgery
- Seems "off" in another way, such as a lack of energy and playfulness, or sleeping more than usual
- Has taken any aspirin or ibuprofen within three days before surgery