Sedation and Anesthesia

General anesthesia puts your child to sleep so that he can feel nothing during surgery or long procedures or if he has a certain medical condition that requires general anesthesia. During anesthesia, your child will have help from a ventilator.

At Children’s Healthcare of Atlanta, your child will be cared for by a pediatric-trained anesthesiologist. Through special training and experience, our pediatric anesthesiologists provide safe care for infants and children with even the most difficult health issues. Our team also plans safe anesthesia for each child based on weight, height and type of procedure.

Sedation uses medications to help your child be relaxed, calm and sleepy (sedated). It is often used during certain medical tests and procedures. It can help your child stay calm, be able to lie still and have less pain.

Children’s has one of the largest pediatric sedation programs in the country. It is staffed by sedation physicians who are trained in pediatric emergency medicine and critical care. Our goal is to give the safest dose of medicine possible; that’s why we give your child medication based on his age and weight.

Children who have sedation:

• Are able to breathe on their own.
• Appear very sleepy but can sometimes still hear you and respond to your voice and touch. Other times, they may be sleeping soundly.
• Have their blood pressure, heart rate and breathing checked often.
• Have a pulse oximeter (a painless type of monitor that records the oxygen level in the blood) attached to a finger or toe.
• May need to wear a safety belt called a medical immobilizer during the procedure to help him stay very still. This is used for your child’s safety.
• May have oxygen given to them during the procedure.
• May or may not remember what happened to them while they were sedated.

How is sedation given to my child?

Medications, such as pain medicines and sedatives, are used to produce sedation. These medications may be given by mouth or through an I.V. line.

Is there any risk from sedation?

Like all medical procedures, sedation involves some risk. If you have questions or concerns, feel free to talk with your doctor or nurse beforehand.

Who gives my child the medication for sedation?

Sedation medications are prescribed by your child’s doctor and usually given by a nurse or doctor.

What are some of the possible side effects of the medication used for sedation?

Side effects depend on the exact medicine used. In general, some side effects may include:

• Nausea and vomiting
• Sleepiness
• Rash
• Itching
• Agitation (crying and restlessness)
• Dizziness
• Unsteady balance
• Amnesia (may forget what happened while sedated)
• Need for oxygen or help with breathing
• Other risks as outlined in the consent form

How long will my child be sedated?

Your child will usually be sedated until the test or procedure is done. Depending on the medication used, he may be sleepy for several hours after it is stopped. If your child is an outpatient, he may need to stay at Children’s for several hours until he is awake enough to go home.

Each child is very different, but some general guidelines to help you prepare your child for sedation include the following:

• Your child will not be able to eat or drink before the test or procedure in which he will need to be sedated.
• If he does eat or drink, the test or procedure may need to be rescheduled.
• Very carefully follow any directions you have been given about not giving your child anything to eat or drink.
• Having an empty stomach can help decrease the risk of problems during sedation. This is very important for your child’s safety.

• You may bring a bottle of juice or formula to give your baby or a snack for your child for after the procedure if your doctor permits.
• Be honest with your child. Keep explanations short and simple, but tell him what will happen.
• Tell toddlers and preschoolers right before you are ready to leave for the hospital.
• Tell school-age children the day before the procedure.
• Tell teens several days before so they can mentally prepare for the procedure.

• If it is going to hurt (needle stick to start the I.V.), talk with your child about it. Let him know it is OK to cry.
• Keep your child in your arms or in the bed with the side rails up after he receives his medication. This can help prevent him from falling.
• Be calm. Your child will usually model your mood and behavior.
• Distract your child. Depending on his age, here are some ideas:
• Hold, cuddle and soothe babies. Use a pacifier.
• Talk or sing in a soothing voice.
• Allow him to hold a favorite blanket or toy from home.
• Read a story.
• Play an electronic game or watch a video.

Using medication to relax your child or make him sleepy puts him at risk for falling down and getting hurt. Your child will need special care when you go home. Our staff will talk with you about specific care for your child. Some general guidelines include:

• Do not leave your child alone until he is completely awake and alert. Watch your child closely for the first hour after discharge. Check him closely every hour after that for six hours.
• Do not give your child anything to eat or drink until he is fully awake and alert, or as your doctor instructs.
• Keep the lights, activity and noise levels low until your child is fully awake so that he can rest well.
• Protect your child from falls, sharp objects and other possible dangers.
• Calm and reassure your child if he becomes restless, agitated or combative from the medication. This does not last long and should wear off within a few hours.
• Your child should not return to day care, school or work for the next 12 to 24 hours.

Age-based instructions

Our goal at Children’s is to give your child the safest possible care. To help keep your child safe and prevent harm, follow the instructions below based on your child’s age.