After the Operation

What to Expect After Your Child's Surgery

After surgery, reassure your child at the bedside.

Recovery Period l PACU | Managing Pain | If Your Child Is Admitted| Readiness to Go Home

Cincinnati Children's Hospital Medical Center offers information about what to expect after your child's surgery.

Recovery Period After Your Child's Surgery

After your child's surgery / procedure, your child will go to the Post Anesthesia Care Unit (PACU). In the PACU, a nurse will be at your child's bedside for the entire recovery period to ensure his / her safety and comfort.

The amount of time children spend in the PACU varies from 15 minutes to several hours, depending on the type of procedure and anesthetic. We will make every effort to reunite you and your child in the PACU as soon as possible.

We will reach you in the surgery waiting area to invite you to your child's bedside. Please do not hesitate to ask the staff in the waiting room for an update from your child's PACU nurse.

What You'll See in the PACU

The PACU is an open room with areas separated by curtains to provide visual privacy for each family. Though it is a very busy place, we encourage each family to focus their attention on their child.

Some children may be affected by the crying of other children. Please know we are working to comfort each child and family.One of our goals is to prevent, minimize or relieve your child's pain as much as possible.

Children are often given medication to help decrease the possibility of pain. Working with you, we will assess your child's pain so that we can offer the most timely and effective treatment. Speak with your nurse or doctor if you are concerned that your child is in pain.

Most children receive oxygen through a face mask for a period of time after anesthesia. Sometimes children look pale, puffy or swollen after surgery. This is normal.

Children wake up differently from anesthesia. Some children wake up quickly and may be awake before their families arrive at the bedside. Other children may still be sleeping from the effects of anesthesia. Please do not wake your child. In our experience, children often have a gentler and more comfortable wake up when they wake on their own.

Children differ in their reactions to anesthetics. Some have an upset stomach and may vomit. Often children are given medications to help decrease the possibility of nausea and vomiting. Some may have dizziness for a period of time. If a breathing tube is used during surgery, some may have a sore throat. This is normal.

Some children wake up shivering though they are not cold. Encouraging your child to take deep breaths will help. Those who have had intravenous (IV) pain medication may have an extremely itchy nose. This itch will go away.

Some children wake up restless or irritable. Some appear awake but are not aware of what is going on around them. Some cry, thrash, arch their back, reach out and seem inconsolable, even when they are in their parent's arms. This behavior is not usually related to pain, and children do not usually remember it.

This restless or irritable wake up is known as "emergence delirium." About one third of young children who have brief procedures experience emergence delirium, but it may occur in children of any age, even after a longer time under anesthesia.

Emergence delirium may be upsetting for you to see, but be assured that it will go away. Sometimes it lasts about 10 minutes. Other times, it lasts up to an hour or longer. By staying calm, speaking softly, and remaining at the bedside, you can be a comfort to your child. Your nurse will be at the bedside to reassure and support you in consoling and comforting your child.

You and your child are welcome to stay in the PACU until this restless or irritable stage passes. However, in our experience, returning to a familiar environment often helps calm children. The most effective way to help your child may be to return to your hospital room or your car. Your child may calm down after the car ride home or a brief nap.

Readiness to Go Home

The amount of time it takes to be ready to go home varies from child to child. Generally, once you and the recovery (PACU) nurse agree that your child is safe AND home care instructions have been reviewed, your child is ready to leave the hospital.

In most cases, it is not necessary for your child to be fully awake and alert or to drink, urinate or walk before leaving the hospital. Your child does need to meet these requirements before leaving:

Breathing is safe
Your child is arousable or awake
Amount of pain is an acceptable level

Your child may have additional requirements depending on his / her health history and surgery / procedure. Please ask your child's doctor or nurse about requirements your child must meet before he / she leaves the hospital.

The staff is sensitive to you and your child's individual needs. Before you leave, we want you to be confident that your child feels well enough to go home and that you are comfortable taking your child home.

Going Home on the Day of Surgery

Your child's doctor and nurse will review general home care instructions with you and will discuss any special recommendations such as follow-up appointment information, return date for school / daycare and strenuous activity, and bathing bandage or wound care.

You will be given phone numbers to call if you have additional questions or concerns. Please feel free to ask questions about the discharge instructions or to request more instruction if you have concerns about taking care of your child at home.

If you go home with a prescription, talk to the pharmacist about how to give the medicine. Be sure to tell the pharmacist about any medications your child takes at home.

When it is time to leave the hospital, most children are able to change into their clothes while in the recovery room. You may carry your child to the exit or use a wheelchair or stroller. You will be escorted to the exit. If you need to stop at the main campus pharmacy, please tell your transporter.

Concerns or Questions After You are Home

If you have concerns or questions about taking care of your child at home, please feel free to call the nurses at the hospital. We are happy to answer your questions and review any discharge instructions with you.

If Your Child Has an Unplanned Admission to the Hospital

Unplanned hospital admission after outpatient surgery is unusual but occasionally occurs. If this happens, your surgeon and / or anesthesiologist will explain the reason to you. Our nurses and other staff members will be available to answer your questions and help you make arrangements for the admission.

What to Expect at Home

Activity When you Get Home

We recommend that you supervise your child's activities closely the day of the operation / procedure. Your child may be drowsy and may nap or sleep on and off the rest of the day. Anesthesia, sedation and pain medications may alter your child's sense of balance. Your child may be unsteady when walking or crawling.

When possible, your child should avoid steps. If that's not possible, be sure to assist your child climbing up and down the stairs. Older children and teens should not participate in biking, sports or driving for 24 hours after the anesthesia / sedation.

We encourage quiet activities such as reading, watching television, playing board games or video games. Many children are able to return to school, day care and regular activities within a day or two. If your child is excessively sleepy and you can't arouse your child readily, call your child's surgeon / doctor.

What to Drink and Eat at Home

Sometimes nausea or vomiting can happen after anesthesia, and it may take awhile before your child is ready to eat. If your child has not had something to drink while in the PACU, you may give clear liquids (water, soft drinks, juices, Kool-Aid, Gatorade, popsicles) as soon as you arrive home. When your child is able to drink clear liquids without vomiting, you may give light foods (soup, crackers and dry cereal) and gradually work up to solid foods. There is no need to force your child to eat, but fluids will probably make your child feel better, so encourage your child to drink.

When your child is drinking enough, he / she should be urinating several times a day and should have tears when crying. If your child experiences some vomiting, wait a little while before attempting clear liquids again, and progress to eating slowly. If your child can not hold down clear liquids and has not urinated within 6 to 8 hours, contact your child's surgeon / doctor.

If Your Child has Discomfort, Fever or Irritability at Home

Your child may have some discomfort, run a slight fever or be irritable following the surgery / procedure. An over-the-counter pain reliever / fever-reducing medicine may be enough to keep your child comfortable. Before giving any over-the-counter medicine, ask your child's doctor / surgeon what medicine is safe for your child.

Your surgeon / doctor may also give you a prescription for pain medication. Another common, temporary side effect after anesthesia is a sore throat or hoarse voice. Cool fluids or popsicles may help. Offer your child reassurance that he or she will feel better.

If your child experiences pain that is excessive or cannot be comforted, call your child's doctor. A slight fever is common for the first 24 hours after surgery / procedure.

If the fever will not reduce with a fever-reducing product and liquids, or lasts longer than 24 hours, especially if there are other signs of infection (swelling, redness, foul smell, drainage), call your child's doctor / surgeon.

Pharmacy on the Main Campus

Prescriptions can be filled at the hospital pharmacy (Location B, first floor). The pharmacy accepts most insurance plans. You may drop off your child's prescriptions while your child is recovering in the PACU area. The pharmacy opens at 9 am Monday to Friday. Closing and weekend hours vary. Acetaminophen (Tylenol) is available at a reduced rate.

Temporary Behavior Changes

Some children show temporary behavior changes for up to two weeks after an operation / procedure. This is normal and temporary. Your child may act younger (suck a thumb) or have new fears (want a light on at night). Your child may show changes in sleeping (restless sleep, may not want to sleep in own bed), eating (poor appetite) or toilet habits (wet the bed), be more dependent / clingy, or withdrawn or moody.

Research shows that this behavior is a response to anxiety that can occur with a stressful situation. Returning to a normal routine at home often helps children feel secure during the recovery period. Be patient and supportive; allow your child to talk about the experience, and give your child time to adjust.