Cardiac Anesthesia

What to Expect

Below is what you can expect before, during and after your child's heart surgery:

• Before the surgery, the anesthesiology team will do a preoperative evaluation to make sure your child can safely undergo anesthesia. An anesthesiology team member will come to the preoperative area to talk to you about your child’s health history, any family history of problems with anesthesia and any illness or infection your child may have. He or she will also perform a physical examination to identify anything that could present a risk during anesthesia.
• The pediatric cardiac anesthesiologist will meet with you to discuss the anesthesia plan for your child. The plan might include sedation or surgical anesthesia during the procedure and medicine and/or regional pain procedures using local anesthetics to control pain during and after surgery. The anesthesiologist will also talk to you about the benefits of anesthesia for your child as well as any risks and how the anesthesiology team will help keep your child safely asleep during surgery. You will be asked to sign a consent form, or if your child is 18 or older, he or she will be asked to sign.
• In most cases, a Child Life specialist will meet with your family before the surgery and may accompany your child into the operating room or cardiac catheterization laboratory (also called the cath lab). Child Life specialists are trained and experienced in working with children and families to make healthcare less stressful and help keep children relaxed and calm during medical procedures. Your child might have a chance to decorate the mask he or she will use to inhale anesthesia medicine or to pick a flavor of lip balm to put inside the mask to make it smell good.
• Some children become anxious before surgery and may receive anti-anxiety medicine before undergoing anesthesia to help them relax.
• When the time comes for surgery, a nurse will take your child to the operating room or cath lab. Before drifting off to sleep, your child might talk to the Child Life specialist, play with a toy, play a game or watch a video on a tablet computer provided by the Child Life Specialist.
• Heart surgery often requires placement of a central venous line, arterial line and intravenous (IV) lines to provide access to the vascular system. Most of these lines can be placed after your child is asleep to prevent undue stress and anxiety. There are some circumstances that might require an IV to be put in while your child is awake. The anesthesiologist will discuss this with you and provide numbing medication so the IV does not hurt.
• Your child’s vital signs will be monitored throughout the surgery and until your child is fully awake. Advanced technology is used to ensure the brain is receiving enough blood to protect the brain and nervous system. For children on IV anesthesia or at an increased risk of waking, a special machine will monitor the level of consciousness to help prevent waking or awareness during surgery.
• At the end of the procedure, the anesthesiologist will stop administering medicine so your child can wake up. He or she may remain asleep or nearly asleep for a few minutes to a few hours, depending on his or her condition and the type of surgical procedure. In some more complex cases, it might be best to keep your child asleep for a few hours or days after the procedure. Your child will be closely monitored and kept comfortable during this time.
• You will be reunited with your child when he or she is stabilized in the recovery room or ICU.

Most children are groggy and might be cranky or confused for a while—perhaps several hours—after waking up. Some children become severely agitated and upset after anesthesia. If this happens, the anesthesiologist can provide mild sedation to help your child calm down and recover. If your child feels nauseated when he or she wakes up, the nurse can provide medicine to help him or her feel better and to prevent vomiting. Keep in mind that any negative effects from anesthesia are usually short-lived.

Before your child goes home or to a hospital room, the anesthesiologist will make sure pain and nausea are controlled and vital signs are within safe ranges. Your child may still be sleepy, cranky or confused for several hours after waking up. In most cases, you can remain with your child during this time, and a Child Life specialist may also be on hand to help you and your child stay calm and comfortable. If your child needs to stay asleep after surgery, he or she will be kept sleepy and comfortable.