General Anaesthesia and Your Child

For any parent, the thought of a child receiving general anaesthesia is very frightening. This is completely understandable, since anaesthesia is unfamiliar to most families. Furthermore, the media occasionally reports a  life-threatening incident associated with surgical anaesthesia. However, the media fails to mention that millions of patients safely receive anaesthesia without any complications. Modern anaesthesia is extremely safe. To calm your worries, Dr. Jasdev Bhalla (Dental Anaesthesiologist) has prepared answers to some common questions.

Why can't you do the procedure under local anaesthesia?
For most young children, the dental procedure cannot be done safely without general anaesthesia. Although local anaesthesia is often used for adults, it is not a common occurance for children at MM Family and Sleep Dentistry. The administration of local anaesthesia is often painful and terrifying to a child. Even the smallest amount of patient resistance and struggle is potentially unsafe during dental procedures. It simply isn't worth the risk.

Can just the smallest possible amount of anaesthesia be used?
Using minimal amounts of anaesthesia can be more dangerous than complete general anaesthesia. In a young child with a small airway, the chance of breathing problems is greater when the airway isn't under the Anaesthesiologist's continual control. When the patient is only lightly anaesthetized (during the beginning and end of the procedure) is the time when patients require the most attention and constant monitoring.
The best analogy is to compare anaesthesia to flying an airplane. Most airplane accidents occur during take-off  and landing, when the airplane is closest to the ground. Similarly, the beginning and end of anaesthesia are the most difficult. Asking the Anaesthesiologist to use only a small amount of anaesthesia would be like asking a pilot to fly just above the tree tops!

Who will give my child anaesthesia? Can I meet that doctor ahead of time?
Your child's anaesthesia will be given by a fully trained and experienced Dental Anaesthesiologist, who may have one or more assistants. You will meet this doctor for a Sedation Consultation appointment before the date of your child's dental procedure.
 
I heard about a case where someone died under anaesthesia. Is it possible?
While it is possible, it is extremely rare for healthy children. The majority of deaths associated with surgeries involve the elderly and extremely ill patients. As previously mentioned, millions of patients safely receive anaesthesia without any complications. The risk of a fatal event under anaesthesia for a healthy child is about 1 in 300,000. Comparatively, the risk of a fatal even while riding in a car is about 1 in 6,500. 

What if my child is allergic to anaesthesia?
There is really no allergy to anaesthesia, but there is a rare condition called congenital muscle disease (malignant hyperthermia). This causes a patient under anaesthesia to become unstable. Every Anaesthesiolgist knows about this condition and knows how to react if it occurs. However, there is no reason to take a muscle biopsy to test for this ahead of time.  

Can I be there when my child goes to sleep?
At MM Family and Sleep Dentistry, our top priority is always the safety of our patients. However, we recognize that the dental procedure date can be a stressful time for the patient and his/her parents. Our office allows one parent to be in the operating room as the child falls alseep. Please be aware that the Dental Anaesthesiologist has the authority to decide who is permitted to enter the operating room. Unfortunately, seeing a parent experience a strong emotional reaction can be unsettling for a child. It is more beneficial to encourage the child to act bravely, and for him/her to enter the operatory with dental staff only. When a parent is upset, it may unnecessarily distract our staff and take attention away from the patient, which is undesirable.  

Can I stay during the procedure?
As previously mentioned, one parent is allowed in the operating room to help soothe the child as he/she falls asleep. Once the dental procedure begins, the parent is asked to return to the reception area. This allows the proper focus to be placed on providing great care for our patient.

Can I be there when my child wakes up? 
Of course, it is hard to be separated from your child when he/she is going through a stressful experience. At MM Family and Sleep Dentistry, we do our very best to make sure that you are separated from your child for the shortest amount of time possible. However, the patient needs to regain a certain level of consciousness before he/she can be safely removed from all monitoring equipment. Most children are partially awake when reunited with parents, but will have no memory of the event until later in the recovery period. 

Why is my child crying in the recovery room?
Unlike adults, most children cry in the recovery room. A child typically wakes up feeling disoriented, frightened, dehydrated, and hungry after the dental procedure. A few children feel nauseated. All of these feelings create a stressful situation for the child. Crying is a natural and healthy response. Most children feel better after 30 minutes or so, once they are more fully awake.

Should you have any more questions regarding General Anaesthesia, please feel free to call our office at (905) 573-6161. Thank you.