General Anaesthetic for a 2yr old - any experience?

[ttalloo]

We are seeing a paediatric plastic surgeon this week to discuss removal of a mole on DS2's wrist (he's 2.4yrs). His dermatologist told us that the surgeon would almost certainly recommend removing it under general anaesthetic to ensure that he doesn't wriggle or squirm during the procedure, which isn't major, but is delicate, and therefore best done when DS2 is immobile.

DH is insisting that we ask for the procedure to be done under local or at least under sedation, because he's afraid of a heavier anaesthetic on DS2's long-term health, but I think it would be better for DS2 to have it under general anaesthetic, just to make sure that he doesn't jog the surgeon's hand, and to avoid frightening him.

I suppose ultimately we'll have to be guided by the surgeon (maybe he just won't want to remove the mole under local anaesthetic or sedation), but I was wondering whether anyone has been in a similar position of being able to choose between a local and a general, and, if you've had a little one who's had a general anaesthetic, how they've coped before and afterwards.

Many thanks.

my ds has had generals for MRI scans. I think with quick procedures they always just put them in deep enough and wake them quickly afterwards. Some people are sensitive to GA and there clearly are some risks which the doc will dicuss. We have thankfully never had a problem with recovery etc. With a general they give them gas to knock them out quick then put in the needles so they really don't feel anything. With a local don't think that would be the case. They may be able to give some kind of sedation plus a local so woozy but no out cold. Best to talk to the drs, ask lots of questions then make your decisions.

My ds1 had one when he was 4 to deal with a hernia, and again a few weeks ago for a follow up op.
I would say a general would be less scarey. DS1 is a hideously nervous patient, the first time, putting him under was very traumatic since he freaked out having the hand canula put in and had to have gas instead. very distressing.
However, the second time, they sedated him before, and the whole process was much calmer, not in the least traumatic.
Recovery was difficult after the first one since he woke up distressed and was in quite a lot of pain, but this is unlikely to be the case for your op, plus as I said, ds is a very very nervous patient and doesnt deal with blood/plasters/anything at all medical very well.
After the second op, he came round still under the effects of the sedation, and it was lovely, as he was very calm. The GA did make him sick a few times, but really it wasn't at all anything on the scale of the last time.
The staff at the hospital both times were excellent and especially the nurses on theday ward were really lovely. They were really sweet to ds, and really very sympathetic when he struggled the first time.
I personally would go for the GA, having this done under a local anaesthetic for a little one might be quite distressing. Good luck, Im sure it will be fine

My DC had a general at 3 and a bit months to remove a fast-frowing cyst on his face. We were advised that he had to have a general for the same reason so he wouldn't fidget during the operation. It was absolutely fine, in fact, the worst aspect of the operation was that he wasn't allowed any food or drink from about midday onward and the operation was then delayed to late afternoon. He was manically hungry and cross I wouldn't breastfeed him. He was only unconscious for about 30 or 40 minutes. Although be prepared for when they put him under - you'll probably be asked to hold him and I found that bit somewhat upsetting. We were then on tenterhooks for the duration of the operation. He was fine afterwards just incredibly hungry. Took both boobs AND a bottle and then conked out. It doesn't seem to have affected his health at all.

It was 20 odd years ago but between the ages of 18 months and three years I had around a dozen surgeries under GA. Mum said I recovered quickly and although I remember bits and pieces from that time i don't remember it being traumatic. I'm now 28 with no related effects.

There aren't any long term health issues for a healthy child having a GA, and barely any risk, either! At least I hope not - DS has had 9 GAs so far, 4 of them before he was 18m old.

It will be much better having it done under a GA, and it will be for a v short time. Your 2 yo will sail through - but you will be a nervous wreck. But it isn't as bad as you imagine.

I refused to have surgery without a GA so I wouldn't ask a 2 year old to do it!

Reading the rest of the thread with interest though as DS is due an op in the summer when he is about 18 months.

The trouble with sedation is that the child/person isn't fully asleep, they can respond to simple instructions etc and therefor are able to move but like a general they have no memory of the procedure taking place.
My DD has had 2 GA's and will be having another at the end of this yr. She has always been fine other than a small struggle as they administered the drug. She woke up fine and recovered from both operations in a text book fashion.
Good luck

Thank you so much for the quick, and reassuring, replies.

Maybe because I've had several GAs since I was five, they don't really scare me as much as they should, whereas DH, who hasn't had an operation since having a hernia removed when he was tiny, is terrified of them.

I just don't want DS2 to be frightened under local or under sedation, or to flail around and cause the surgeon to cut in the wrong place.

But in any case, we'll speak to the paediatrician and see what he recommends - and I think I'll have more confidence in standing my ground with DH now that I know from your experiences that a GA for a young child is not the nightmare he thinks it is.

Thanks again!

My DS (needle/blood phobic) had GA age 7 - he remembers nothing at all about any of it ! They sedated him to put the canula in and whipped it out again before he woke up.

My DS had a general when he was about 18 months old to remove some skin from his mouth - probably the same type of operation, not major surgery but delicate. He recovered pretty quickly, he came around and was allowed home within a few hours.

AFAIK serious complications of GA are very very rare. And I think - although check this with your anaesthetist cos I am no doctor - that whereas old anaesthetic drugs used to just knock you out, now you are very sedated, so it isn't so heavy.

When a surgeon tells you that your child should have a general, they have weighed up the risks of a GA against the inevitable distress your child will experience going through the procedure with just a local. When they recommend a general it is for good reason. You're not the first parents to worry about this stuff. My friend is a surgeon and has parents ask her often whether their child could have a local, but she really believes that a general is often preferable to the child becoming very upset, the op taking longer as a result etc.

My DD1 had some GAs at about 12 months. Other than an issue on one occasion with how long the hospital kept her nil by mouth (far too long, we threw quite a wobbler over it) it was fine. She woke up and ate like a horse and had no effects from what I could see. I, on the other hand...

My ds was 3 weeks old when he had GA. He is 2.7 now and seems perfectly fine. :)

DS4 who is 7 has had 13 GA so far for various surgeries both investigative, minor and major. He recovers well after them. I would think the possible psychological trauma of undergoing a procedure without a GA would outweigh any concerns about having one.

ds had ga at 20 month to repair a hydrocele. the operation went well, he was put under on my lap with gas and the needles were put in after he was asleep. we were allowed home 2 hours after the operation after he had something to eat and drink.
unfortunately the next evening he came down with pneumonia, probably due to the breathing tubes. it is rare but can happen. a course of antibiotics and some rest sorted that out.

GAs are very safe these days and as a toddler would I hope have a specialist paediatric anaesthetist - so very experienced with children. DGS had one and was absolutely fine - his mum was a quivering heap on the floor, but thats normal for her. pfb of course

xxx love you J

It will be a teeny whiff to do such a small operation, it will be fine.
I've had a three year old under ga to set a broken wrist and another 3.5 year old for a tonsillectomy and they were both fine. Hope it goes well!

As others have said I really wouldn't worry too much about having a GA and if it is considered a necessary / helpful part of the op I would go with the advice that your doctors are giving you. My DD had one a few months back (aged 3) and will have another next summer when she will be 4. I went into theatre with her and held her while she was put to sleep, once she was under she was lifted out of my arms and laid on the operating table. It was a bit scary and weird for me, but she was fine about the whole process. I had to leave at that point and the only bad experience was that when I was called to come to the recovery ward she had already woken up before I got there and I could hear her screaming all the way down the corridor as she was lost and disorientated without me being there. She calmed down as soon as I arrived though and within and hour or two was bouncing around as normal. I didn't notice any after effects.

My DS had a GA aged 3 to remove a cyst. When it's elective surgery they examine your child carefully first and will not proceed with the op if they think there is any possible problem (my friends ds had his operation delayed because he had a slight cold for example) My DS' operation went smoothly. He was already coming round as they brought him back up, they gave him something to eat and drink and we went home an hour later! At home he seemed normal apart from being a little sleepy. We were advised not to let him climb stairs on his own for the first day or two, but he got in a bad mood and charged up the stairs and into his bedroom before I had even reached the foot of the stairs! By the next day he was up bright and early and was completely normal, apart from being a little sleepy by late afternoon. A nurse rang us first thing in the morning to check that everything was fine. There were certainly no long term effects from the GA. It was scarey for us and I didn't sleep for about a week prior to the op! But I'm glad we proceeded with the op as it all went very smoothly.

My DD2 was sedated at 6m to have an MRI and CT scan done, she was fine for the duration of the MRI but when she was moved to the CT scanner she woke up and was quite upset till we got her back off to sleep. It seemed the sedation was fine whilst she wasn't being touched or moved but she was definately aware of movement and touch so perhaps it wouldn't be suitable for a procedure as such? DD2 has also had 2 GA's, the first at 2.2yrs and the second a few weeks later and although she was a little distressed with the gas, she was out quick and didn't seem to remember anything about it after. No problems after coming round either, a little groggy, had a few tears then asked where the chocolate was on her biscuit!!! I think it's best to take the advice of the Paed and Paed Anaesthetist. Good luck :-)

Ttalloo - glad you have been reassured. My son has had 4 GA's between the ages 5 and 6 and if/when your son goes in for the GA I can recommend watching the "Hospital" episode of Something Special beforehand (you can buy it on DVD). It will help your son understand what will happen as he will be able to see it rather than just explaining. Preparation is key and knowing in advance what is going to happen may allay any fear Get your DH to watch it too

We have had GA's, again preparation is the key especially as to what it will be like when they wake up.

DD1 (4) was a nightmare with the canula but DD2 (9) had a tooth out recently and was a star.