Any tips for ASD child needing day surgery under GA?

[AgnesDiPesto]

DS has to have some baby teeth out and due to tolerance issues / lack of understanding this is going to have to be done under GA. He is 8 and moderate / severe ASD with phrase speech. I've requested a meeting in advance (with and without DS) to take photos etc. I am expecting the cannula to be an issue. Not sure yet how they will put him to sleep. Or how I will keep him from wanting to bolt off the ward when he comes round. Any advice or tips welcome. So far the ward has said they have a play therapist who can help prepare him but tbh I am doubtful that will be helpful as DS doesn't really do play. He's better with a list of rules and a schedule broken down step by step. Any tips and advice welcome. I can almost guarantee the things DS will freak out about will be things I haven't thought of.

My asd ds had this done when he was 8. They had allocated him 2 nurses and a side room on his own.they told us take him in what ever would make him comfortable he took hisvlaptop. A nurse wheeled his laptop down to theatre on a table to get him there. He wouldn't cooperate when he came to putting him under so it took 4 of them to pin him that was the hardest part. After he was to groggy to bolt of when he came to after an hour they sent him home with advice if he had after effects he was supposed to stay 4 hours after but was getting distressed so they decided it was better for him to come home.

DS (3) has recently had adenoidectomy / tonsillectomy under GA. He is pre-verbal, ASD and GDD. There was no way I could explain or he'd understand so I was very very anxious about how things will play out. I asked a lot of questions at the pre op appt and explained his needs in detail so the staff are prepared for his reactions. Chose the gas mask over the cannula as getting the cannula in and keeping it in would be impossible if he was feeling and seeing it. 3 nurses and DH held his arms leg and face while I cuddled him, the anaesthetist held the mask over his face till he was asleep. He screamed, cried, kicked etc (he's very strong for his age, touch wood) and tbh it was heart breaking esp when I put him on the trolley, kissed him and left but I just reminded myself that I did it because it was for his best interest :( They did put a cannula in but in OT and wrapped it up in a bandage as we had discussed earlier so although he was very intrigued by it afterwards, he couldn't figure out what it was and how to take it off hehe

The saving grace was Peppa Pig on his tablet or our phones. Just make sure you have enough internet data on your tablet or phones though as videos take up tonnes of it!!! He was very subdued (unlike his usual self) after the op and just wanted to lie on the bed watching cartoons and only really resisted when it was time for obs or medication. If there is any to be given after the op, I assume painkillers, you can ask for suppositories if your DS has a difficult time with oral medication like my DS. He still had to be held down :( but at least the full dose was in him rather than spat out.

Hope it goes well .

Oh just as an afterthought....they do a lot of observations at regular intervals during the time the child is there before and after the procedure like temperature, blood pressure, heart rate etc so may be a good idea to pretend doing those to him and him to you at home a few times so he sort of gets used to whats coming. I can see from your op that he responds better to schedules and set out rules so maybe making that pretend play of obs as part of routine from maybe a few days pre procedure may help with lowering anxiety during those as that messes up their measurements too. We couldn't do that with DS so had to stick on a probe on his foot and put a sock over it for the entire time but every time he moved his foot too much the machine beeped crazily

Thanks so much
We are stuck with 2nd slot as already had to wait months and moving to 1st slot will mean having to do it 3 days before we go on holiday and i just don't want to be doing it that week.
Useful to know can have cannula in when asleep - i can't see them getting it in otherwise
He can't eat after 6.30am will have to get there at 12.30 and go in around 3 (which just makes me doubt they know anything about asc)
The waiting before should be ok (except the not eating) its the rest of it
We really want to avoid him having to be held down as it would make him reluctant to ever go to hospital again (he would remember it forever)

we had surgery twice but DD was younger (4). cannula was impossible so we took her out with gas. she really fought the gas mask but it wasn't a long battle. was not nice to see her so upset (I had to come into the room where they anetheitise her and hold her) but it was OK (did not take long anyways). cannula came in once DD was asleep.