I'm looking forward to meeting you in the Portland Hospital. These are simple guidelines to help you prepare your child for the forthcoming operation. I will explain further when we meet in hospital. If you have anything you wish to discuss before we meet, you can send me an e-mail, just look in the quick guide.

Food and fluids:

Our operating schedule begins at 08.00.

Clear drinks (e.g. water, apple juice or sparkling drinks) may be given up to 2 hours before the operation.

No food (including milk) should be taken after midnight and drinks must not be given after 6 am, unless advised otherwise by the nurses on the ward. The nurses will have an estimate of the time of your child's operation and they will help you with pre-operative fluids.

Breast fed babies may have a last feed 4 hours before surgery.

You can read general guidelines on food and fluid intake by clicking here.

Premedication:

Daycases: No sedative premedication will be given. If anaesthesia is going to be started by an injection, local anaesthetic ('magic') cream (EMLA) will be put on the hand two hours before the start of the operation, when the last drink is given.

Children staying overnight: Sedatives slow recovery and are usually avoided, but if you feel that your child is very anxious about their operation, a short acting medication may be taken by mouth. If anaesthesia is going to be started by an injection, local anaesthetic ('magic') cream (EMLA) will be put on the hand, when the last drink is given.

The Anaesthetic Room:

I would be very pleased if you would accompany your child to the anaesthetic room, both parents may come. You will be collected by the theatre porter and your ward nurse will accompany you to the anaesthetic room. Your child may walk (if they have not had premedication), be carried or sit on the theatre trolley for the journey down to the basement.

I will have explained how anaesthesia will be started when we meet, but as a general rule infants and children less than 4 years old will be given anaesthetic gas to breathe, whilst older children will receive an injection.

They may sit either on your lap or on the theatre trolley during induction of anaesthesia.

Anaesthesia means being unaware and it allows operations to be conducted in safety. There are three components to anaesthesia, relaxation, analgesia (pain relief) and anaesthesia itself. Anaesthesia is not like natural sleep and there are two ways of commencing, inhalational or intravenous.

However anaesthesia is induced, if your child is on your lap, as they are going off to sleep my assistants and I will help you to lift them onto the trolley. I will look after them from then on.

Some parents find the onset of anaesthesia in their child to be distressing, this is a normal and common reaction.

Where shall I wait?

I will have given you an idea of the length of the operation when we meet, please remember this will be an estimate and it may take longer than anticipated to complete the surgery. If things seem to be taking longer than you expected don't worry - it doesn't mean that anything is wrong.

For long operations it is better to wait in your room where you can try to relax. Please DO NOT LEAVE the hospital in case we need to talk to you during the operation.

For short operations (less than 1 hour) it is better to wait downstairs in the X-ray waiting area, your nurse will show you where to wait. The advantage of waiting here is that you are adjacent to the post anaesthesia care unit (recovery) and the recovery nurses will come and get you when your child is waking up, thereby cutting out delays engendered by phone calls, coming to find you and your having to get yourself downstairs. Bring something to read with you! You MUST REMAIN WHERE YOU HAVE BEEN ASKED TO WAIT, please do not wander around the theatre area distracting the theatre staff from their duties. Remember your child's well-being depends upon the theatre team devoting their whole attention to his or her care.

The Recovery Room:

After the examination or operation your child will be cared for in the anaesthetic recovery area, the recovery nurses will be looking after your child at this stage. When your child is waking up and when it is safe to do so, the recovery nurses will come and get you if you are waiting downstairs. For longer operations when you are upstairs, the recovery nurses will call the ward, sister will come and get you from your room and take you down to the recovery area, to be with your child during the final stages of anaesthetic recovery. Once the recovery nurses are happy that it is safe for your child to return to the ward the theatre porter will help you return to your room.

When your nurse calls you to collect your child, ask to walk down the stairs its much quicker!

Please note that the Recovery team may also be caring for adult female patients when your child is ready for collection, under these circumstances males may be asked not to enter the recovery ward. If a father is the sole guardian please let the ward sister know, it may be possible to make special arrangements.

How will my child be in the recovery?

In the very early stages of recovery children are often quite irritable and may cry - please prepare yourself for this. This doesn't mean that they are in pain, instead it is often due to confusion and disorientation. They will be re-assured by your presence and voice - please talk to them. When guided by the nurses you may cuddle you child. When it is safe to do so, the recovery nurses will arrange your tranfer back to the ward. You will be accompanied by your ward nurse and a theatre porter.

Pain Relief:

For operations on the penis, orchidopexies and hernias, a local anaesthetic block will be done once general anaesthesia is established, in addition paracetamol (Calpol) and diclofenac will be given by suppository.

For other operations, a powerful painkiller such as morphine will be used and a morphine drip will be given afterwards. A local anaesthetic block may also help.

I will discuss pain relief in detail when we meet.

Further information on pain control and what to do at home is available by clicking here.

Fluids after the operation:

For daycases, small quantities of clear fluids may be started as soon as your child has fully awoken from the anaesthetic and when he or she indicates that they are ready to drink. An intravenous drip will be used for other operations and we will discuss post-operative feeding when we meet.

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