Anaesthesia for Ear, Nose & Throat Surgery

Anaesthesia for E.N.T. surgery primarily involves young children. The common operations are tonsillectomy, adenoidectomy and insertion of grommets. Mostly the surgery is elective, and is often day only.

Children presenting for surgery commonly have suffered a number of infections involving the throat and ears. This results in the children failing to thrive and missing school.

Obstruction of the airway (snoring and sleep apnoea) is another indication for surgery.

Children from about two years upwards do best when parents explain as much as possible about their hospitalisation and operation.

Pre operative preparation involves obtaining the best control of medical conditions such as asthma and continuation of any antibiotics or other treatment. ASPIRIN should not be given to children.

After admission to hospital and before surgery, your anaesthetist will visit you and your child. At this time you can discuss any queries or fears you have about the proposed operation and anaesthetic. Your anaesthetist will collect information about your child's medical and anaesthetic history and about your family's history.

Most anaesthetists do not give any premedication but some like to sedate children before surgery with a syrup. Some anaesthetists order an EMLA Patch (a local anaesthetic to numb the skin) to be applied to the back of the child's hand where it is contemplated to insert a small needle for safety before the anaesthetic is administered. Many anaesthetists induce anaesthesia with a mask ('gaseous induction') and insert the needle after the child is asleep so EMLA is not required.

Virtually all anaesthetists prefer to have one parent accompany the child to the operating theatre and to remain while the child is going off to sleep. Children do well with constant reassurance from parents at this stage.

Children often cry on arousal from anaesthesia. They will mostly settle with reassurance. Simple analgesics like paracetamol are adequate in most instances. Encourage your child to drink as much as possible after surgery.

E.N.T. surgery in adults is mostly to clear nasal obstruction or middle ear surgery. Ear surgery often causes nausea but newer medications are very effective in preventing or alleviating this.

Most E.N.T. surgery is relatively minor and there is a tendency for discharge from hospital on the same day

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