General Anaesthetic / for 4 Year Old

[LDN1]

Hi all,

Following on from my last thread regarding some dental issues with our DD4, there are two teeth that never fully formed and they are causing issues. We have been given the options (we see a well respected specialist this weekend so will see if there's any other options) - of a potential crown situ' or removal of the two teeth in question.

Now... with DD4 being very timid and nervous, we've already been told that gas might not be an option, which leaves general anaesthetic.

Of course, with her being only 4, we have some reservations and anxiety about that. Rather than lean on Google and the rabbit hole that might bring, I wanted to ask on here... has anyone else had their child, as young as 4, go under GA?

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

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 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.

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 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!

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 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.

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

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.

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.

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.

The thing I wasn't prepared for was how quick it all is - if it all goes to plan, they'll probably put numbing cream on both hands, decide which to use, you'll go up, they'll administer the drugs, and it's all really quick. I was there with mine when he went under and was whisked away very quickly, as soon as his eyes closed. I was a bit "hang on that's my baby" (he was 7 and it was grommets , not an emergency) but yeah, that was the worst bit for me.

Hi op! I recently posted about my child needing a potential 8 teeth out and was going to be under GA.
Our son is 5 and basically we're told two teeth HAD to come out and because some of the others had the very starting signs of decay that it's easier just to whip them all out...
Me and DH sought a second opinion and honestly I'm so glad we did. Our boy had one tooth removed under local anaesthetic and a cap put on the tooth behind. Then just yesterday he went for his second appointment and exactly the same treatment again on the other aide of the mouth.

Firstly, I was 100% sure my son wouldn't go along with having a tooth out locally as he is super shy and sensitive. But he did it! Secondly, I think it's worth seeking second opinions.
We actually saw 3 different dentists - the original one, the one they referred us too since the original one thought he'd need GA and then the third one which was my husband's dentist.

Maybe finding a good paediatric dentist who can put your child at ease is the way forward rather than going to GA option?

One of mine had a GA at 3 to repair an umbilical hernia. She'd had it since she was 8 weeks old and we had only seen the hospital the previous morning for a referral for surgery. The hospital phoned us at lunchtime with a next day cancellation which meant we didn't have time to worry about it. It was scary watching the wonderful anaesthetist putting her under but he engaged with her and made us both so much more relaxed.

just clarifying a couple of points mentioned here.... sedation (oral/ sometimes nasal) is commonly given to children who need it before they have their general anaesthetic. Not all children need it though and anaesthetists are pretty good at spotting the ones who'll be fine and those who'll need a pre-med. Although it is often possible to do a gas induction, that isn't always appropriate and for some children IV is both quicker and safer. We often use a sedative pre-med before a gas induction as well as IV for those children for whom the whole trip to theatre might be traumatic. Breathing vapour through the face mask is the anaesthetic - the cannula that goes in after a gas induction is for giving the rest of the medications needed (pain relief/anti-emetics etc).

Ask the anaesthetist about a pre med. Midazolam given by mouth is the commonest option nowadays (unless it's changed in the couple of years since I retired!) It tastes a bit unpleasant but works quickly and is generally effective. The downsides are that it can delay recovery and just occasionally it makes a child over stimulated rather than sedated. Plus there's the issue of getting them to take it, which if you have a child who is worked up and anxious already can be a challenge on occasion -we've probably all experienced trying to give our own children medicine of some kind when they're not feeling cooperative!
My personal practice re premeds was not to give one to a patient of any age, not just kids, unless there was a specific reason. Even with small children you can often gain sufficient cooperation with patience, distraction and a bit of flexibility (sometimes literal...I've anaesthetised children in some unconventional positions before now!) But I would always listen to parents especially if there were prior adverse experiences. All anaesthetists have their own "style" and techniques that they know work well in their hands but nobody knows a child like the parent and if they have had multiple procedures before it is a foolish doctor who doesn't at least listen to what they have to tell you about previous events. If your child has found medical procedures traumatic before, do let the anaesthetist know. Of course we can't guarantee to make everything stress free but forewarned is forearmed and we will generally do the best we possibly can to reduce anxiety.

DS was almost 3 when he had his first GA for adenoids.

Stayed with him while they administered it, cried buckets as he went to sleep - it does hit you and it is emotional leaving your precious child in the hands of strangers. But they're professionals and it was over quickly.

He came round fast and was off playing not long after.

He had GA again 2 years ago and was absolutely fine that time too. He's 10 now

My son is older at just turned 9 but he’s had at least 25 or more GA’s at this point within the past 9 months including 2 in one week more than once.

The risks are minimal, he’ll be absolutely fine.

Your DS will be fine OP.

My DS had a GA to remove his tonsils and adenoids when he was 23 months. Later, after he woke up he was singing a nursery rhyme!

My son had it for grommits at two. He went under fine. Was a bit upset and discombobulated when he woke up but I think that might have been because I wasn't there (they call you when they wake up). I came to find him and he had about four nurses fussing and Peppa Pig on one of their phones. He had about three biscuits and then was fine!

4 no but just shy of his 6th birthday, yes. All was well.

I had an absolute fit when they tried the gas mask with me at that age, and it’s one of my earliest memories. They did gen anaesthetic in the end.

Mine had 3 between the ages of 2 and 4! Each time he came out of it differently, but was generally fine! They first time he sadly did aspirate when under, he was meant to be in as a day case but they ended up keeping him in overnight and x-raying his chest, however there were no issues and he was home the next day! They times after that he had no complications, hwoever the second tim3 he was really disressed when he came round for a few hours! Third time, no issues at all!
I didn't go with him when he was put under, his dad did - it knew I'd find that bit hard to watch, however his dad said it was ok, he cuddled him and he kinda went floppy and fell asleep!

My 3 year old has had 14 general anaesthetics. They usually have the play staff who are amazing at keeping the kids entertained playing games and watching things on the ipad, blowing bubbles ect to distract as they put the mask on to put them off to sleep. Usually they try to use gas to put them to sleep and then place a cannula once they are asleep. My wee one now has a port so doesn't have the gas to go to sleep as they put the medicine directly through the port instead. You will be allowed to stay with her until she's asleep and they'll let you give her a kiss and cuddle. It can be a bit upsetting seeing them go to sleep as sometimes they jerk a bit and resist it, but it's totally normal and she won't remember a thing.

Mine used to have a hickman line but now has a picc line which is a good job because he hates the mask.

I’m sorry your little one has had to have so many too.