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Consequences of general anesthesia in children. How do children recover from general anesthesia? How long does it take for a child to recover from anesthesia after surgery?

The topic of anesthesia is surrounded by a considerable number of myths, and all of them are quite frightening. Parents, faced with the need to treat a child under anesthesia, are usually worried and apprehensive. negative consequences. Vladislav Krasnov, an anesthesiologist at the Beauty Line group of medical companies, will help Letidor figure out what is true and what is false in the 11 most famous myths about childhood anesthesia.

Myth 1: a child will not wake up after anesthesia

This is the most terrible consequence, which moms and dads are afraid of. And quite fair for someone who loves and caring parent. Medical statistics, which mathematically determines the ratio of successful and unsuccessful procedures, also exists in anesthesiology. A certain percentage, although fortunately negligible, of failures, including fatal ones, does exist.

This percentage in modern anesthesiology, according to American statistics, is as follows: 2 fatal complications per 1 million procedures; in Europe it is 6 such complications per 1 million anesthesias.

Complications in anesthesiology occur, as in any field of medicine. But the tiny percentage of such complications is a reason for optimism among both young patients and their parents.

Myth 2: The child will wake up during the operation

When using modern methods Anesthesia and its monitoring can guarantee with a probability close to 100% that the patient will not awaken during the operation.

Modern anesthetics and anesthesia monitoring methods (for example, BIS technology or entropy methods) allow precise dosing of drugs and monitoring of its depth. Today there are real opportunities to receive feedback on the depth of anesthesia, its quality, and expected duration.

Myth 3: the anesthesiologist will “give an injection” and leave the operating room

This is a fundamentally misconception about the work of an anesthesiologist. Anesthesiologist – qualified specialist, certified and certified, responsible for their work. He is obliged to remain constantly with his patient during the entire operation.

The main task of an anesthesiologist is to ensure the safety of the patient during any surgical procedure.

He cannot “get an injection and leave,” as his parents fear.

Also deeply incorrect is the common perception of an anesthesiologist as “not quite a doctor.” This is a doctor medical specialist, which, firstly, provides analgesia - that is, the absence of pain, secondly - the comfort of the patient in the operating room, thirdly - the complete safety of the patient, and fourthly - the calm work of the surgeon.

Protecting the patient is the goal of the anesthesiologist.

Myth 4: Anesthesia destroys a child's brain cells

Anesthesia, on the contrary, serves to ensure that brain cells (and not just the brain) are not destroyed during surgery. Like any medical procedure, it is performed according to strict indications. For anesthesia these are surgical interventions, which without anesthesia will be disastrous for the patient. Since these operations are very painful, if the patient remains awake during them, the harm from them will be incomparably greater than from operations that take place under anesthesia.

Anesthetics undoubtedly affect the central nervous system - they depress it, causing sleep. This is the meaning of their use. But today, in conditions of compliance with the rules of administration and monitoring of anesthesia using modern equipment, anesthetics are quite safe.

The effect of the drugs is reversible, and many of them have antidotes, which, when administered, the doctor can immediately interrupt the effect of anesthesia.

Myth 5: Anesthesia will cause allergies in your child.

This is not a myth, but a fair fear: anesthetics, like any medical supplies and foods, even pollen, can cause allergic reaction, which, unfortunately, is quite difficult to predict.

But an anesthesiologist has skills, drugs and technical means in order to combat the effects of allergies.

Myth 6: Inhalation anesthesia is much more harmful than intravenous anesthesia

Parents are afraid that the inhalation anesthesia machine will damage the child's mouth and throat. But when an anesthesiologist chooses a method of anesthesia (inhalation, intravenous, or a combination of both), he assumes that this should cause minimal harm to the patient. An endotracheal tube, which is inserted into the child's trachea during anesthesia, serves to protect the trachea from getting into it. foreign objects: fragments of teeth, saliva, blood, stomach contents.

All invasive (invading the body) actions of the anesthesiologist are aimed at protecting the patient from possible complications.

Modern methods inhalation anesthesia involve not only tracheal intubation, that is, placing a tube into it, but also the use of a laryngeal mask, which is less traumatic.

Myth 7: Anesthesia causes hallucinations

This is not a fallacy, but a completely fair remark. Many of modern anesthetics are hallucinogenic drugs. But other drugs that are administered in combination with anesthetics can neutralize this effect.

For example, the almost universally known drug ketamine is an excellent, reliable, stable anesthetic, but it causes hallucinations. Therefore, a benzodiazepine is administered along with it, which eliminates this side effect.

Myth 8: Anesthesia is instantly addictive and the child will become a drug addict.

This is a myth, and a rather absurd one at that. IN modern anesthesia drugs that are not addictive are used.

Moreover, medical interventions, especially with the help of any devices, surrounded by doctors in special clothing, do not cause any positive emotions and the desire to repeat this experience.

Parents' fears are unfounded.

Used for anesthesia in children medicines, which have a very short validity period - no more than 20 minutes. They do not cause a child either a feeling of joy or euphoria. On the contrary, when using these anesthetics, the child actually does not remember events from the moment of anesthesia. Today it is the gold standard of anesthesia.

Myth 9: the consequences of anesthesia - deterioration of memory and attention, poor health - will remain with the child for a long time

Disorders of the psyche, attention, intelligence and memory are what worries parents when they think about the consequences of anesthesia.

Modern anesthetics - short-acting and at the same time very well controlled - are eliminated from the body in as soon as possible after their introduction.

Myth 10: Anesthesia can always be replaced with local anesthesia

If the child is to surgery, which due to its pain is performed under anesthesia, refusing it is many times more dangerous than resorting to it.

Of course, any operation can be performed with local anesthesia– that’s how it was 100 years ago. But in this case, the child receives a colossal amount of toxic local anesthetics, he sees what is happening in the operating room and understands the potential danger.

For a still unformed psyche, such stress is much more dangerous than sleep after the administration of an anesthetic.

Myth 11: Anesthesia should not be given to a child under a certain age.

Here the opinions of parents differ: some believe that anesthesia is acceptable no earlier than 10 years, while others even push the acceptable limit to 13-14 years. But this is a misconception.

Treatment under anesthesia in modern medical practice carried out at any age if indicated.

Unfortunately, a serious illness can affect even a newborn baby. If he is undergoing a surgical operation during which he will need protection, the anesthesiologist will provide protection regardless of the patient’s age.

Many medical procedures are so painful that even an adult, much less a child, cannot endure them without anesthesia. Pain, as well as fear associated with surgery, is a very serious stress for the baby. Thus, even a simple medical procedure can cause such neurotic disorders, such as urinary incontinence, sleep disturbances, nightmares, nervous tic, stuttering. Painful shock can even cause death.

The use of painkillers helps to avoid discomfort and reduce stress from medical procedures. Anesthesia can be local - in this case, an anesthetic drug is injected into the tissue directly around the affected organ. In addition, the anesthesiologist can “switch off” the nerve endings that carry impulses from the part of the body on which surgery is being performed to the child’s brain.

In both cases, a certain area of the body loses sensation. In this case, the child remains fully conscious, although he does not feel pain. Local anesthesia acts locally and has virtually no effect on the general condition of the body. The only danger in this case may be associated with the occurrence of an allergic reaction to the drug.

Actually, anesthesia is called general anesthesia, which involves turning off the patient’s consciousness. Under anesthesia, a child not only loses sensitivity to pain and plunges into deep sleep. Usage various drugs and their combinations gives doctors the opportunity, if necessary, to suppress involuntary reflex reactions and reduce muscle tone. In addition, the use of general anesthesia causes complete amnesia - after medical intervention the baby will not remember anything about the unpleasant sensations experienced on the operating table.

How dangerous is anesthesia for a child?

It's obvious that general anesthesia has a number of advantages, and in cases complex operations it is definitely necessary. However, parents often worry about the negative consequences that anesthesia can cause.

In fact, the use of anesthesia in children is associated with a number of difficulties. Thus, a child’s body is less sensitive to certain drugs, and in order for anesthesia to work, their concentration in the child’s blood must be an order of magnitude higher than in adults. Associated with this is the danger of an overdose of anesthetics, which can cause hypoxia and other complications from the nervous and cardiovascular system, up to cardiac arrest.

Another danger is associated with the fact that it is more difficult for the child’s body to maintain a stable body temperature: the thermoregulation function has not yet had time to develop properly. In this regard, in in rare cases develops - a disorder caused by hypothermia or overheating of the body. In order to prevent this, the anesthesiologist must carefully monitor the body temperature of the small patient.

Unfortunately, there is a danger of an allergic reaction to the drug. In addition, a number of complications may be associated with certain diseases from which the child suffers. This is why it is so important to tell the anesthesiologist before the operation about all the characteristics of the child’s body and previous illnesses.

In general, modern anesthetics are safe, practically non-toxic and do not themselves cause any negative consequences. With a properly selected dosage, an experienced anesthesiologist will not allow any complications.

Carrying out most surgical operations these days is unthinkable without adequate anesthesia. Despite the fact that general anesthesia has long been successfully used in pediatrics, parents are frightened by the prospect of it. little baby- scare possible dangers and complications after surgery, the question of the consequences for the child is of concern. Parents should be aware of the intricacies of the procedure and contraindications to it.

Some manipulations with a child cannot be performed without general anesthesia.

General anesthesia- This special condition organism, in which, under the influence of special drugs, the patient falls into sleep, total loss consciousness and loss of sensitivity. Children do not tolerate any medical manipulations, so when major operations it is necessary to “turn off” the baby’s consciousness so that he does not feel pain and does not remember what is happening - all this can cause severe stress. The doctor also needs anesthesia - diverting attention to the child’s reaction can lead to mistakes and serious complications.

Children's body has its own physiological and anatomical features– The ratio of height, weight and body surface area changes significantly as we grow older. For children under three years of age, it is advisable to administer the first medications in a familiar environment and in the presence of their parents. It is preferable to carry out induction of anesthesia at this age using a special toy mask, diverting attention from unpleasant sensations.

Carrying out mask anesthesia for a child

As the child grows older, he or she tolerates manipulations more calmly - a child of 5-6 years old can be involved in introductory anesthesia - for example, invite the child to hold the mask with his hands or blow into the anesthesia mask - after exhalation it will follow deep breath drug. It is important to choose the right dosage of the drug, since the child’s body reacts sensitively to exceeding the dose - the likelihood of complications in the form of respiratory depression and overdose increases.

Preparation for anesthesia and necessary tests

General anesthesia requires parents to carefully prepare the baby. It is necessary to examine the child in advance and pass necessary tests. Typically required general analysis blood and urine, examination of the coagulation system, ECG, pediatrician’s report on general condition health. On the eve of the operation, a consultation with an anesthesiologist who will administer general anesthesia is required. The specialist will examine the child, clarify the absence of contraindications, and find out the exact body weight for calculation. required dosage and will answer all questions parents may have. It is important to make sure there is no runny nose - nasal congestion is a contraindication to anesthesia. Other important contraindication to anesthesia - an increase in temperature for unknown reasons.

Before general anesthesia, the child must be examined by doctors.

The baby's stomach must be completely empty during anesthesia. Vomiting during general anesthesia is dangerous - children have very narrow respiratory tract, therefore the likelihood of complications in the form of aspiration of vomit is very high. Newborns and infants up to one year old last time receive the breast 4 hours before surgery. Children under 1 year of age who are in artificial feeding, maintain a fasting pause of 6 hours. Children over 5 years old have their last meal the night before, and 4 hours before anesthesia it is contraindicated to drink plain water.

How is anesthesia administered in childhood?

The anesthesiologist always tries to minimize discomfort from anesthesia for a child. To do this, premedication is carried out before the operation - the baby is offered sedatives, relieving anxiety and fear. Children under the age of three or four years already in the ward receive drugs that put them into a state of half-sleep and complete relaxation. Small children under 5 years old experience separation from their parents very painfully, so it is advisable to stay with the child until he falls asleep.

Children over 6 years of age usually tolerate anesthesia well and enter the operating room conscious. The doctor brings a transparent mask to the child’s face, through which oxygen and a special gas are supplied, which causes anesthesia for children. As a rule, the child falls asleep within a minute after the first deep breath.

Introduction to anesthesia occurs differently depending on the age of the child.

After falling asleep, the doctor adjusts the depth of anesthesia and carefully monitors vital signs - measures blood pressure, monitors the condition skin child, evaluates heart function. In cases where general anesthesia is administered infant up to a year, it is important to prevent excessive cooling or overheating of the baby.

Anesthesia for children under one year old

Most doctors try to delay the moment of administering general anesthesia to a baby for up to a year as far as possible. This is due to the fact that in the first months of life there is active development most organs and systems (including the brain), which at this stage are vulnerable to adverse factors.

Conducting general anesthesia for a 1 year old child

But if there is an urgent need, anesthesia is given at this age - anesthesia will cause less harm than no necessary treatment. The greatest difficulties in children under one year old are associated with observing a fasting break. According to statistics, infants less than a year old tolerate anesthesia well.

Consequences and complications of anesthesia for children

General anesthesia is a rather serious procedure that carries a certain risk of complications and consequences, even taking into account contraindications. It is believed that anesthesia can cause damage neural connections in the brain, promotes increased intracranial. At risk for developing unpleasant consequences children under 2-3 years old are considered and younger age, especially those with diseases nervous system. However, it should be noted that similar symptoms in most cases, developed with the introduction of outdated anesthetics, and modern anesthetics have minimal side effects. In most cases unpleasant symptoms passed some time after the operation.

Children under 2-3 years of age endure anesthesia the hardest

From probable complications development is considered the most dangerous anaphylactic shock, which occurs when you are allergic to the injected drug. Aspiration of gastric contents is a complication that is more common in emergency operations when there was no time for appropriate preparation.

It is very important to choose a competent anesthesiologist who will evaluate contraindications, minimize the risks of developing unpleasant consequences, select the correct drug and its dosage, and also quickly take action in case of complications.

The topic of anesthesia is surrounded by a considerable number of myths, and all of them are quite frightening. Parents, faced with the need to treat a child under anesthesia, are usually worried and afraid of negative consequences. Vladislav Krasnov, an anesthesiologist at the Beauty Line group of medical companies, will help Letidor figure out what is true and what is false in the 11 most famous myths about childhood anesthesia.

Myth 1: a child will not wake up after anesthesia

This is the worst consequence that moms and dads fear. And quite fair for a loving and caring parent. Medical statistics, which mathematically determine the ratio of successful and unsuccessful procedures, also exist in anesthesiology. A certain percentage, although fortunately negligible, of failures, including fatal ones, does exist.

Complications in anesthesiology occur, as in any field of medicine. But the tiny percentage of such complications is a reason for optimism among both young patients and their parents.

Myth 2: The child will wake up during the operation

Using modern methods of anesthesia and its monitoring, it is possible with a probability close to 100% to guarantee that the patient will not awaken during surgery.

Myth 3: the anesthesiologist will “give an injection” and leave the operating room

This is a fundamentally misconception about the work of an anesthesiologist. An anesthesiologist is a qualified specialist, certified and certified, who is responsible for his work. He is obliged to remain constantly with his patient during the entire operation.

The main task of an anesthesiologist is to ensure the safety of the patient during any surgical procedure.

He cannot “get an injection and leave,” as his parents fear.

Also deeply incorrect is the common perception of an anesthesiologist as “not quite a doctor.” This is a doctor, a medical specialist who, firstly, provides analgesia - that is, the absence of pain, secondly, the patient’s comfort in the operating room, thirdly, the complete safety of the patient, and fourthly, the calm work of the surgeon.

Protecting the patient is the goal of the anesthesiologist.

Myth 4: Anesthesia destroys a child's brain cells

Anesthesia, on the contrary, serves to ensure that brain cells (and not just the brain) are not destroyed during surgery. Like any medical procedure, it is performed according to strict indications. For anesthesia, these are surgical interventions that, without anesthesia, will be disastrous for the patient. Since these operations are very painful, if the patient remains awake during them, the harm from them will be incomparably greater than from operations that take place under anesthesia.

The effect of the drugs is reversible, and many of them have antidotes, which, when administered, the doctor can immediately interrupt the effect of anesthesia.

Myth 5: Anesthesia will cause allergies in your child.

This is not a myth, but a fair concern: anesthetics, like any medications and products, even plant pollen, can cause an allergic reaction, which, unfortunately, is quite difficult to predict.

But an anesthesiologist has the skills, medications and technology to combat the effects of allergies.

Myth 6: Inhalation anesthesia is much more harmful than intravenous anesthesia

Parents are afraid that the inhalation anesthesia machine will damage the child's mouth and throat. But when an anesthesiologist chooses a method of anesthesia (inhalation, intravenous, or a combination of both), he assumes that this should cause minimal harm to the patient. The endotracheal tube, which is inserted into the child's trachea during anesthesia, serves to protect the trachea from foreign objects entering it: fragments of teeth, saliva, blood, and stomach contents.

All invasive (invading the body) actions of the anesthesiologist are aimed at protecting the patient from possible complications.

Modern methods of inhalation anesthesia involve not only tracheal intubation, that is, placing a tube into it, but also the use of a laryngeal mask, which is less traumatic.

Myth 7: Anesthesia causes hallucinations

This is not a fallacy, but a completely fair remark. Many of today's anesthetics are hallucinogenic drugs. But other drugs that are administered in combination with anesthetics can neutralize this effect.

Myth 8: Anesthesia is instantly addictive and the child will become a drug addict.

This is a myth, and a rather absurd one at that. Modern anesthesia uses drugs that are not addictive.

Moreover, medical interventions, especially with the help of some kind of equipment, surrounded by doctors in special clothes, do not evoke any positive emotions in the child or a desire to repeat this experience.

Parents' fears are unfounded.

For anesthesia in children, medications are used that have a very short duration of action - no more than 20 minutes. They do not cause a child either a feeling of joy or euphoria. On the contrary, when using these anesthetics, the child actually does not remember events from the moment of anesthesia. Today it is the gold standard of anesthesia.

Myth 9: the consequences of anesthesia - deterioration of memory and attention, poor health - will remain with the child for a long time

Disorders of the psyche, attention, intelligence and memory are what worries parents when they think about the consequences of anesthesia.

Modern anesthetics - short-acting and at the same time very well controlled - are eliminated from the body as soon as possible after their administration.

Myth 10: Anesthesia can always be replaced with local anesthesia

If a child is undergoing a surgical operation, which, due to its pain, is performed under anesthesia, refusing it is many times more dangerous than resorting to it.

Of course, any operation can be performed under local anesthesia - this was the case 100 years ago. But in this case, the child receives a colossal amount of toxic local anesthetics, he sees what is happening in the operating room, and understands the potential danger.

For a still unformed psyche, such stress is much more dangerous than sleep after the administration of an anesthetic.

Myth 11: Anesthesia should not be given to a child under a certain age.

Here the opinions of parents differ: some believe that anesthesia is acceptable no earlier than 10 years, while others even push the acceptable limit to 13-14 years. But this is a misconception.

Treatment under anesthesia in modern medical practice is carried out at any age if indicated.

Surgery under general anesthesia in a person of any age causes anxiety. Adults recover from anesthesia in different ways - some recover from the procedure easily, while others recover poorly, taking a very long time to recover. Children, besides general violation well-being, do not realize what is happening and cannot adequately assess the situation, so surgery under general anesthesia can become a lot of stress. Parents are worried about the consequences of anesthesia, how this will affect the child’s well-being and behavior, and what kind of care their children will need after waking up.

Recovery period after surgery under general anesthesia

A little about anesthesia

Modern anesthesia drugs have virtually no effect negative influence on the child and are quickly eliminated from the body, which provides easy period recovery after general anesthesia. For anesthesia in children, in most cases, inhalation methods of administering the anesthetic are used - they are absorbed into the blood in a minimal concentration and excreted unchanged by the respiratory system.

Helping your baby after recovery from anesthesia

Recovery from anesthesia occurs under strict control an anesthesiologist and begins immediately after stopping the administration of the anesthetic. The specialist closely monitors the child’s vital signs, assessing the effectiveness of breathing movements, level blood pressure and the number of heartbeats. After making sure that the patient’s condition is stable, he is transferred to the general ward. It is advisable that the parents wait in the child’s room - the unpleasant state after anesthesia usually frightens children, and the presence loved one will help you calm down. In the first hours after waking up, the baby is lethargic, lethargic, and his speech may be slurred.

Girl in the ward after surgery

When using modern drugs their elimination period lasts no more than 2 hours. At this stage, you may experience unpleasant symptoms such as nausea, vomiting, dizziness, pain in the area surgical intervention, elevated temperature. Each of these symptoms can be relieved by taking certain measures.

Nausea and vomiting are common side effects of general anesthesia. It has been noted that the likelihood of vomiting is associated with blood loss - with extensive bleeding, the patient vomits in very rare cases. If a child feels nauseous, it is not recommended to eat for the first 6-10 hours after surgery; liquid can be taken in small quantities so as not to provoke a new attack of vomiting. As a rule, relief occurs a few hours after recovery from anesthesia. If the child’s condition has deteriorated significantly and vomiting does not bring relief, you can ask the nurse to give an injection antiemetic drug.
Dizziness and weakness are the body’s natural reaction to anesthesia in the first hours after waking up. It takes some time to recover and it will be better if the child sleeps for a few hours. If for one reason or another sleep is impossible, you can distract the baby with cartoons, a favorite toy, an interesting book or a fairy tale.
Trembling is a consequence of impaired thermoregulation. It is recommended to arrange a warm blanket in advance to help keep your child warm.
An increase in temperature is usually observed on the first day after surgery. This reaction of the body is considered normal when the values do not exceed subfebrile levels. An elevated temperature a few days after surgery suggests the development of complications and requires additional examination.

A nurse measures a girl's temperature after surgery

General anesthesia has the greatest impact on babies under one year of age. Infants have developed a clear diet and sleep schedule, which becomes confused after anesthesia - children can confuse day and night, staying awake at night. In this case, only patience will help - after a few days or weeks the baby will return to his usual routine on his own.

In rare cases, parents observe that their child “fell into childhood,” that is, he began to perform actions that are not typical for his age. You don’t have to worry about this; most likely, this is a temporary phenomenon and will go away on its own.

Some children, after surgery using general anesthesia, sleep poorly, are capricious, and refuse to eat. Some rituals that should be performed every day before bed can help your child fall asleep. This could be a glass of warm milk, interesting fairy tales or a relaxing massage. TV viewing should be limited - frequent change pictures provoke excitement of the nervous system; even the most familiar harmless cartoons can increase sleep disturbances.

Feeding a child after anesthesia

If the baby feels well, sleeps well, and is not bothered by fever, nausea or vomiting, then doctors advise returning to ordinary life. Early patient activation helps rapid recovery and prevention of development postoperative complications. After 5-6 hours, doctors may allow your child to eat. The food should be light - it can be vegetable soup, jelly with crackers or toast, porridge with water. Infants receive breastfeeding or formula milk.

In the absence of vomiting, drinking plenty of fluids will help you recover quickly. Clean is best still water, compotes, fruit drinks, teas. Juices and sweet carbonated drinks are not recommended for frequent drinking, as they contain large number Sahara.

Correct psychological preparation, the presence of loved ones and following all the doctor’s recommendations will help the child cope easier. postoperative period. The child’s body has the ability to recover quickly, and within a few days the baby will feel much better than on the first day after surgery.