General Anaesthetic / for 4 Year Old

Around 1200 babies are born every year with a cleft lip and/or palate, and typically undergo surgery at around 6 months old (or shortly afterwards). DS2 had had about 4 GAs by the time he was 2.

Your 4yo will be fine.

Mine did at 3, Emergency Op, It took a bit of time for the penny to drop "he'll need to go to sick kids, we can't do GA here"

They knocked him out with gas in my arms as soon as he was out he was whipped out my arms onto a bed and I was removed from the room.

I don't know how I thought they'd fix him up but I knew it was beyond my first aid box.

All of this - DD was 2 when she had her first grommets and she came round FURIOUS
45 minutes of screaming and then suddenly stopped and ate several biscuits. Had replacement grommets when she was 4 and the same thing happened but I was ready for it That time she was able to tell me she didn't remember going into theatre, let alone the mask on her face, nor recovery or being upset. All fine.

I’d had three ga’s by that age and I’m now a strapping 47 yr old

My son (autistic as mentioned) has previously had a small dose of midazolam as a sedative. Made him hilariously high as a kite and he remembered very little after it had kicked in. Did mean he was sleepier than usual coming round though but they just let him sleep it off.

My daughter did aged 4 and was fine and I did myself at the same age for the same operation. I actually remember it quite fondly, it was an interesting experience

My DS when he was about 3. He had to have an operation that took a couple of hours. He had a pre-med first that made him dozy. I went down with him for the anaesthetic then they called me back down once he started to come round after the operation. He was absolutely fine, didn’t need to stay overnight and bounced back far faster than I did when I had a general as an adult!

I had a GA aged 4 and still remember it 40yrs on. Not in a bad way though! I had a grommet inserted for glue ear and something with adenoids.

Maybe the whole thing had been discussed with me by my parents repeatedly, I don't know? I got to theatre and didn't recall anyone ever explaining it to me. I still recall seeing the black mask (they weren't clear back then) coming over my face and then being cannulated in the back of my left hand. I didn't panic, because I'd heard an aunt talk about surgeries with my mum. I think people under estimate how much a small child takes in!

There might be children's books about having an operation you can talk through with your DD beforehand or get some dolls and play act the staff etc. I'm sure some sedation and modern techniques will have improved things now too.

My severely autistic son had to have some teeth out just before he was five it was fine and very straight forward ,for him me however I cried my my eyes out as the put him under apparently it's a very normal reaction for parents so just be prepared.

Sedation usually just refers to general anaesthetic. It’s safer to have an established airway. My hospital is GA only, no sedation.

if your little one (or anyone of any age!) is scared of needles they can use what is called a gas induction. This is breathing vapour through a face mask which will send them to sleep enough for us to get their cannula in and give them drugs for general anaesthetic.

My 4 year old did in September just gone. To take adenoids out and drain fluid causing repeat inner ear infections. He was absolutely fine. I bought a children's book about hospitals and operations and we read it a lot and I told him about what was going to happen. It was hard seeing him go under but I kept my nerve until I got the confirmation he was sleeping. It was harder for me than him😅 he was honestly absolutely fine

My 20mo had a GA for an inguinal hernia. Obviously no choice so I didn’t have to wrestle with the decision but he was 100% fine.

I was a quivering wreck and may never be the same again, but that’s parenting!

Yes, he's had a lot of teeth out. They are SO fantastic with kids in my experience, and really know how to make it all very calm and interactive.

The sedative was an oral gel which she said tasted nasty but she forgot all about it very quickly (she was more concerned about being hungry).

@Starryknightcloud One of the reasons my DD had a sedative was because last time she had to have a blood test it took four people to pin her down to get the blood. It was horrific so they agreed to administer the anaesthetic by inhaler and gave her a sedative to keep any anxiety at bay. The cannula went in once she was asleep. I was nervous but it was a really peaceful experience for her.

Mine was fine going in, had a sedative but she had a really rough time coming around. She was extremely upset for a few hours, really hysterical. But thats not the norm, even the nurses were surprised. She did manage to calm down, went home and had a good nap and was fine in few hours. We did need to have her surgery done, it was painful and distressing on the day but it made her life a lot easier in the long run,

Jumping onto the OPs thread to ask about the sedation beforehand another poster mentioned above. Is that common and how is it administered?

Also have a preschooler due a couple of surgeries and haven't had any since they were a baby. They do however have a fear of needles/canulas and can fight like a cat so wanting to be ready to discuss options!

I help put children aged 3 and above to sleep for surgery most days. Happy to answer specific queries

My son has ongoing health needs and he been under GA several times for various different things since he was around 6 months old. I remember being very anxious in the run up to it. He is usually given gas to go off to sleep and then once asleep they insert cannula and switch to that to give sedation. It’s all very quick and the staff are great but I’ve never got used to seeing him sedated.

Our eldest went under GA to have a hydrocele removed when he was this age (it hadn't resolved and they recommended surgery & we wanted to get it done & healed before he started reception at school)
It was nerve wracking for me & dad (him being a dr made it worse I think) but he was absolutely fine
He was fine with it and easily distracted with a new Lego set. Harder to keep him off it to heal mind.

Mine had a few GAs at that age, most traumatic bit was the 6am departure from home to the hospital for a 7am check in. Mine is also autistic and even that didn't cause any issues, they were great with him throughout.

With dental work I would always opt for GA in a child that age over developing a potential lifelong dental phobia

DS2 had a GA age 2 and it was quite difficult to be honest. He had to have gas as they couldn't see a vein and he fought and thrashed about as it took effect. He came round and was fighting - he was knealt up on the bed as they wheeled him back to the ward.

DD had one, age 5 and it was a completely different experience. They used gas too and held it under her chin initially as she drew on an iPad. Totally calm and peaceful. She also woke up easier too.

DD also needed dental work more recently. She is autistic and has huge anxiety and sensory difficulties. She managed inhalation sedation absolutely fine, though she is 10 now - so maybe that could be an option for your DC? I'm not sure what age they offer that from

I understand why you're anxious OP, and in all honesty it's not a the most enjoyable experience you'll ever have. I have anaesthetised thousands of young children over my career but I still found it stressful when my own DS had to have repeated anaesthetics when he was between 4 and 6 years old. But the risks of a planned procedure in a healthy child really are very low and your DD will be looked after by experienced staff who do this kind of thing very regularly and will understand your concern. I'd tell you not to worry but I know that's easier said than done! The biggest help is probably to understand more about what will happen. You should get info from your own hospital but the Royal College of Anaesthetists has some good resources to help prepare children and their parents which are worth a look.
https://www.rcoa.ac.uk/patients/patient-information-resources/information-children-parents-carers

One of mine did when she was 2. Had a wee op inside her ears. Was fine and bounced back very quickly.

And actually her daughter just had a wee op a couple of months ago, at age 14 months. Again no issues, recovered very quickly. The worst part was the fasting beforehand.