Anesthesia

Anesthesia is the use of medicines that change signals to the brain to alter consciousness, block sensations of pain, and relieve anxiety to enable patients to safely and comfortably undergo diagnostic tests, medical procedures, surgery and other treatments. Children may also be given medicine to help them relax or sleep during medical tests and procedures.

In pediatric cancer, anesthesia may be used during:

• Imaging scans when children need to lie very still
• Procedures such as the placement of a central line or port
• Biopsy or lumbar puncture
• Radiation therapy
• Surgery

Depending on the type of procedure and patient needs, anesthesia may be used to:

• Reduce stress and anxiety
• Block pain
• Cause sedation or loss of consciousness
• Relax muscles
• Help patients stay motionless
• Alter or block memory of the procedure

The goal of anesthesia is to keep patients safe and comfortable before, during, and after tests and medical procedures.

Anesthesiology

Anesthesiology is the medical practice of anesthesia. A doctor trained to give anesthesia and monitor patients is called an anesthesiologist. Other key anesthesia specialists include Certified Registered Nurse Anesthetists (CRNAs).

Types of anesthesia

There are three main types of anesthesia: general, regional, and local.

• General anesthesia causes a complete loss of consciousness. This is often described as a “deep sleep.” But unlike normal sleep, stimuli such as pain do not cause a response. General anesthesia medicines are often given through a vein (intravenously or IV). Some medicines may be inhaled by breathing through a mask or breathing tube.
• Regional anesthesia blocks pain or causes a loss of feeling to a larger area of the body by affecting a group of nerves. Examples of regional anesthesia are blocking pain to an arm or leg or epidural or spinal anesthesia which blocks pain to a region of the body such as the legs or belly.
• Local anesthesia causes numbness or blocks pain to a small, specific area of the body. The medicine might be given as a shot or as an ointment or spray applied to the skin. An example of local anesthesia is numbing the skin before treating a cut.

The medicines used during anesthesia depend on several factors: 

• Type of procedure
• Duration of the procedure
• Age and size of the child
• Health conditions and other medical needs
• Prior anesthesia history
• Allergies or reactions to certain medicines

What are NPO instructions?

NPO instructions provide guidelines on when to stop having food or drink before anesthesia. NPO is short for a Latin phrase which means “nothing by mouth”. Patients will be told not to eat or drink for a period of time before procedures. This is important to keep patients safe. Having anything in the stomach during anesthesia puts patients at risk for getting food or liquid in the lungs. Even chewing gum or sucking on hard candy could delay procedures. Families should also talk to the care team about the child’s medicines. The care team may recommend changes to medications before or after anesthesia. It is important to take medicines exactly as instructed.

Risks of anesthesia

The anesthesia care team takes important steps to ensure the safety of patients. However, there are risks with anesthesia. Usually, side effects are minor and go away on their own. After sedation, patients may be drowsy, have a headache, or feel nauseated. General anesthesia may cause side effects such as nausea and vomiting, feeling cold, chills, sleepiness, trouble thinking, and loss of coordination or balance during recovery.

Other complications may be more serious. Certain medicines can cause heart, blood pressure and breathing problems in some patients. Learn about a reaction called malignant hyperthermia. Patients who have serious medical conditions are at higher risk for problems related to anesthesia. Anesthesia specialists anticipate risks and take steps to minimize them. The anesthesia team will closely monitor patients during anesthesia and recovery.