How is Anesthesia Used During ENT Surgery?
The Department of Anesthesia at Cincinnati Children's provides services for about 11,000 ear, nose and throat procedures each year. These are mostly outpatient procedures, such as:
- Placement of ear tubes
- Adenoidectomy (removal of the adenoids)
- Tonsillectomy (removal of the tonsils)
We focus on providing a safe general anesthetic with a rapid recovery and minimal side effects.
Before Surgery
Before the operation, your child will be assessed and prepared for surgery. You will be asked questions about your child's medical history, allergies, current medications, previous anesthetic experience and current health status.
Your child's airway, heart and lungs will be examined. If your child is running a fever, wheezing, has a productive cough or a cold, or vomiting and diarrhea, your anesthesiologist may choose not to do the procedure for your child's safety.
Our goal is for your child to feel safe and happy in our environment. A member of the nursing or Child Life Department will explain what the day will be like, in a child-friendly manner.
If your child is extremely anxious, your child may be sedated with a medication that can be taken by mouth 10 to 15 minutes before going to sleep for surgery. This helps relax the child, makes separation from the parents smoother and often provides amnesia so the child does not remember the experience. However, most children do not need this sedative.
During Surgery
For placement of ear tubes, a short general anesthetic is given and maintained by having your child breathe anesthetic gas through a mask. Placement of an intravenous line (IV) is normally not required.
Anesthesia providers will monitor your child closely during surgery. Routine equipment will check on the heart's electrical activity, blood pressure and oxygen levels in the blood.
Children normally recover within 15 to 20 minutes, with minimal side effects. The whole process, from surgery until discharge, usually takes about an hour.
General anesthesia for tonsillectomy and adenoidectomy usually begins by having your child breathe anesthetic gas through a mask. In older children, an intravenous (IV) technique may be used. Children anesthetized via a mask will receive an IV line once they're asleep. Once your child is asleep, the airway is kept open by the placement of a breathing tube and the use of anesthetic gases.
Anesthesia providers will monitor your child closely during surgery. Equipment will check on the heart's electrical activity, blood pressure, oxygen levels in the blood and breathing (measuring inhaled oxygen and exhaled carbon dioxide concentrations).
During surgery, your child will receive medications to treat pain, prevent nausea and vomiting and reduce airway swelling.
After Surgery
Common side effects may include drowsiness, sore throat, nausea and vomiting and noisy breathing.
The IV is usually in place until your child is ready to go home. Children normally spend about an hour in the Post Anesthesia Care Unit (PACU).
Most children who have their adenoids / tonsils removed will receive a dose of Tylenol / acetaminophen during their stay. Check with the Recovery Room nurse so that the next dose of Tylenol / acetaminophen may be given at the correct time at home.
Some patients may need to be admitted to the hospital after a tonsillectomy or adenoidectomy. Please plan for the possibility of an overnight stay. These include patients who:
- Have sleep apnea (breathing stops for 10 seconds or longer during sleep)
- Are younger than 3 years old
- Have other significant medical problems
- Live far away from Cincinnati Children's
- Have breathing problems, nausea and vomiting after surgery
