Is Your Child Undergoing Surgery

The fact that children will undergo surgery for various reasons causes more anxiety and tension for parents than for the children. Therefore, these surgeries are actually a serious test for parents. That's why we inform you about what needs to be done while preparing your child for surgery, during the surgery, and after the surgery. The surgical process causes more stress for the parents. Because they are the ones primarily responsible for preparing the child for this process.

The information they provide to their child during surgical preparation, the suggestions they make, and the emotions they convey are crucial in determining how the child will experience this process and its aftermath. Since the consequences of a surgical intervention performed during childhood will be carried by children throughout their lives, surgeries should be performed by well-trained Pediatric Surgeons who are knowledgeable about the most disciplined and modern treatment techniques and who can provide the most optimal treatment. Additionally, most surgeries in pediatric surgery are performed on an outpatient basis worldwide. That is, children begin feeding on the same day and are sent home.

Days before the surgery

Medications, vitamins, and herbal supplements

Heart, asthma, or seizure medications should be taken up to the day of surgery. On the day of surgery, you must follow your doctor's instructions. Vitamin supplements and herbal supplements that are not considered essential medications should be discontinued a few days in advance. You should follow the instructions provided by your doctor regarding aspirin-type medications or similar drugs that affect bleeding time. Unless your doctor gives specific instructions to the contrary, allergy medications and painkillers/fever reducers containing paracetamol can be taken until midnight before surgery. If insulin or other diabetes medications are being used, they should not be administered on the day of surgery because the patient will be fasting. The doctor's instructions are important for these medications as well.

Skin lesions and other diseases

As the scheduled surgery date approaches, if your child develops any condition such as a rash, injury, bruising, or diaper rash in the surgical area, you should contact your doctor. As the surgery approaches, if your child develops a feverish illness, a runny nose, or a cough, you should notify your doctor; as a precaution, the surgery may need to be postponed for 7-14 days. In this case, a prior examination will prevent the anxiety you may experience on the day of surgery. A new date will be scheduled. Vaccinations generally do not pose a barrier to surgery, but if your vaccination schedule conflicts with the surgery date, you should inform your doctor.

What should be considered regarding food and drink before surgery?

Unless your doctor has given separate instructions, your child's intake of food and drink should be stopped according to the following guidelines:

• Breast milk intake should be completed 4 hours before the surgery time for infants up to 6 months old, 5 hours for infants between 6 months and 1 year old, and 6 hours for infants between 1 and 2 years old.
• For other foods, consumption should be completed 2-6 hours in advance for children aged 2-6 years. Older children should not eat anything after 24:00 and should not consume liquids containing food (such as fruit juice, ayran, or milk).
• Only water is allowed; intake is restricted to small amounts (sips) for the last 2-4 hours.
• The amount of breast milk and other foods administered should also be slightly less than usual, and foods such as cake, eggs, sausage, salami, and sucuk should not be given.
• In some special cases like intestinal surgery, what can and cannot be eaten a few days beforehand.
• your doctor will give you a list about it.

The day of surgery

Before arriving

Your child should have a bath the night before or on the morning of the surgery. If they can brush their own teeth, you should have them brush before leaving. Your child should not have any jewelry, hair clips, makeup, nail polish, or nail polish remover on. You should bring appropriate storage cases for contact lenses, removable orthodontic appliances, and similar items. If your child has a sleep aid or favorite toy, you may bring it with them to the surgery. If the hospital stay will exceed one day, you should bring button-front pajamas and underwear. The hospital team will provide you with all necessary support regarding other matters you may require.

Once you arrive at the hospital

The anesthesiologist will share with you the most appropriate and safe anesthesia method for your child based on their evaluation. The anesthesiologist will obtain the necessary consents from you, the parents, and will complete any missing tests if required, preparing your child for the surgery time. Twenty to thirty minutes before the surgery time, a sedative medication is administered by mixing it with fruit juice. Through the effect of the medication, your child is ensured to be brought to the operating room without crying or experiencing agitation (extreme restlessness, incoherent excitement), and afterward, to have no memory of their arrival in the operating room or departure to their room.

Points to be considered after surgery

• Your surgeon will personally provide you with information about the surgery at the most appropriate time.
• After your child is taken to the room, you will be told when they can start taking water and other foods. For minor surgeries, this period varies between 30 minutes and 2 hours.
• A limited number of adult visitors are allowed in your room. Crowded visitors will make both you and your child feel uneasy and is also unhealthy.
• When being discharged, a prescription is provided for the medications that need to be taken; usually, only a painkiller is recommended.
• Your surgeon and the ward nurse will explain when you can take a bath at home, what to pay attention to regarding your diet, how to use the prescribed medications, whether wound care is required at home, your follow-up appointment date, and other matters. Usually, bathing is possible after 2-3 days; most pediatric surgery procedures do not require dressing changes or suture removal.

References:

• American Pediatric Surgical Association. Parent & Family Resources – Pediatric Surgery Information.

• Turkish Pediatric Surgery Association. Pediatric Surgery Information Guides.

• Turkish Society of Anesthesiology and Reanimation. Preoperative Evaluation and Fasting Periods Guide.

• Royal College of Anaesthetists. Information for Parents and Carers About Anaesthesia for Children.

• World Federation of Societies of Anaesthesiologists. Guidelines for the Safe Practice of Pediatric Anesthesia.

• National Institute for Health and Care Excellence. Perioperative Care in Children and Young People (NICE Guidelines).