Anaesthesia for ENT disorders in children represents a significant challenge and the Anaesthetist. Anaesthesia for this should be undertaken by the most senior Anaesthetist available.The main Anaesthetic implications are: a potentially hypovolaemic child, a full stomach of swallowed blood, repeat anaesthesia, a potentially difficult airway.
Pre op Evaluation:
Before the operation, your child will be assessed and prepared for surgery. You will be asked questions about your child’s medical history, allergies, current medications, previous anesthetic experience and current health status. Your child’s airway, heart and lungs will be examined. If your child is running a fever, wheezing, has a productive cough or cold, or vomiting and diarrhea, your anesthesiologist may choose not to do the procedure for your child’s safety.
For Day case ENT Procedures, a short general anesthetic is given and maintained by having your child breathe anesthetic gas through a mask. Placement of an intravenous line (IV) is normally not required and can be difficult to get.
General anesthesia for tonsillectomy and adenoidectomy usually begins by having your child breathe anesthetic gas through a mask.Once your child is asleep, the airway is kept open by the placement of a breathing tube (endotracheal tube) and the use of anesthetic gases.
Anesthetist will monitor your child closely during surgery. Monitoring equipment will check on the heart’s electrical activity, blood pressure, oxygen levels in the blood and breathing (measuring inhaled oxygen and exhaled carbon dioxide concentrations).
During surgery, your child will receive medications to treat pain, prevent nausea and vomiting and reduce airway swelling.
Your child after extubation is kept in the post op recovery ward with you until he is fully awake, start drinking and then
child is sent home or moved to the room.Common side effects may include drowsiness, sore throat, nausea and vomiting and noisy breathing. Children normally spend about an hour or two in the Post Anesthesia Care Unit.
(Here a 3 year old child underwent an ENT procedure under general anesthesia in Jubilee Hospital Trivandrum, India and the child is being extubated by Dr.Thomas, the senior anesthetist)