Having a child undergoing surgery can be anxiety provoking for both child and parent alike. Children of all age groups cope better with unusual situations if they have an idea of what is going to happen and why it is necessary. If a child is not prepared, the whole experience can be a traumatic one.

General information regarding medications and supplements to avoid before an operation, and fasting times, can be found by following this link.

child dressed up as a surgeon looking in teddy bear's throat


We would recommend talking to your child truthfully about why they need to come into hospital, as this gives them time to ask questions and prepare. How you approach this, and in what timeframe, will depend on the age of your child:

  • Toddlers: 1 or 2 days before surgery. Toddlers generally require only simple explanations of what is going to happen, with limited information, as complex explanations may simply confuse them. An example would be “We are going to the hospital, and the doctor is going to make your ears better”.
  • Preschool: 3 to 5 days before surgery. Preschoolers have better retention, and reinforcement over a few days helps concepts develop, and gives them a chance to understand and ask questions.
  • School age: at least 1 to 2 weeks before surgery.
  • Teenagers: when surgery is decided upon, as teens have sufficient experience and understanding that they should be included in decision making about their health care.

The worst thing a parent can do before surgery is to not prepare their child at all. The change in routine, being surrounded by unfamiliar people, being given an anaesthetic and waking up without any understanding of why they might be in some discomfort, can be confronting and traumatic for a child. Children may then understandably act out, and be left with a fear of hospitals, doctors, nurses, and health care in general.


  • Use educational role play – using a favourite toy to help your child understand what is going to happen. Use bandages (eg. on the arm of a teddy bear to simulate where an intravenous drip will be wrapped up), simulate taking medicine, use a toy doctors kit to examine the toy.
  • Books about going to hospital – several books have been written for children on this topic. Your local library will often be able to assist.
  • Repetition and reassurance – children will absorb more information each time you talk about the subject. If you approach the topic with confidence and reassurance, they will feel much better about the whole process.
  • Involve your child in getting ready to go to hospital – the day before, get your child to help with packing a bag for hospital, picking out their favourite pyjamas, and deciding which toy they would like to bring with them.
  • Involve childcare, kindergarten, school – as your child might spend a lot of time in these environments, positive reinforcement from teachers and caregivers can be helpful.


Children take cues from their parents. They look to their parents to know what to expect and how to respond. Many children will adopt their parent’s attitude about healthcare and surgery. If you are prepared and confident, you will be better able to prepare your child and help them to feel more confident and reassured as well.

Make sure you are comfortable with what is going to happen, and if unsure, feel free to ask questions of your surgeon, hospital, and anaesthetist.

It is also important that your body language matches your words. If a parent is saying, “It’s going to be OK,” but their body language says, “I’m terrified”, the child will usually adopt the attitude of fear.


Hospitals have evolved from the days of whisking a child away and not allowing parents to stay, to being a family friendly environment as much as possible. One parent can generally stay at all times except during the operation and in the recovery room. A bed will be provided for a parent staying overnight. On the ward, you will shown the play room and kitchenette.

On the day of surgery bring in:

  • pyjamas / dressing gown / slippers and toilettries (for both of you if you are staying overnight)
  • nappies (if required)
  • formula or special dietary needs (if required)
  • a favourite toy or comfort item
  • books, ipads or electronic games
  • photos of family or pets, if you wish
  • all relevant x-rays or scans

Make sure you:

  • take time out for yourself – having a child undergo surgery is a stressful experience. Make sure you take time to look after yourself so you can adequately look after your child.
  • are aware of hospital visiting hours for friends and family.
children dress up as surgeons



Pre-medicating children prior to surgery is rarely required. Occasionally, because of circumstances such as autism, or high anxiety, this may be appropriate. If you think your child might benefit from pre-medication based on past experience, make sure you talk to the anaesthetist prior to the day of surgery.

Gas or intravenous anaesthesia

Younger children will usually have a “gas induction”. An anaesthetic gas agent such as Sevofluorane will be used via a mask gently held near your child’s face. As they breathe the anaesthetic, they drift off to sleep. They often go through a wriggly phase, which can look unusual, but is a normal phase of going to sleep, just more noticeable with an anaesthetic. It is unusual to use muscle relaxants and mechanical ventilation in children – they are kept in a plane of anaesthesia where they are unaware, but still breathing for themselves.

Older children will typically have anaesthetic cream applied to their hands and arms, to allow placement of a drip cannula with minimal discomfort. Anaesthesia can then be induced with intravenous medications, quickly and safely.

Anaesthesia for children is very safe, and life threatening complications very rare. You anaesthetist will discuss the appropriate method and potential complications associated with anaesthesia, in most cases on the day of surgery.

Recovery room

The recovery room is designed to support patients until they are safely over the effects of the anaesthetic, and to ensure pain relief is adequate prior to return to the ward. There is a high ratio of nursing staff to patients at all times. As soon as your child is awake, they are returned to the ward. In general, parents are not allowed in the recovery area, in view of other patient’s privacy and to minimise disruption to the high level care that is required. Occasionally exceptions will be made, if the child requires additional comfort during this period.

It is a good idea to bring a favourite toy, and this can be left on their bed in the operating room, so they have something familiar when they wake up.


happy childrenImmediately after surgery, preschool children are often irritable and more difficult to deal with than normal. Often they have a further snooze, as anaesthetic effects wear off, and then wake up in a more alert state.

Some children go through a phase of “emergence delirium”, which can be quite confronting for parents. This occurs as the body is awake, but the brain hasn’t quite caught up yet. They can look quite distressed and inconsolable, but will often “snap out” of the delirium after a finite time. Having this once does not imply it will happen again at the next anaesthetic, and vice versa.

During longer term recovery, children go through an adjustment period. Each child is different, and how they respond to the experience of surgery and any discomfort afterwards will vary, just like in adults. Preschoolers will often be more difficult to deal with than is normal, and may become clingy. As difficult as it may be, it is important to exhibit patience with your child during this trying time. This will settle as your child’s life returns to normal. Additional support from friends or family during this stressful time, can be very helpful.

Sometimes, night terrors are seen for 1 to 2 weeks. This is more prevalent in children who have tonsils and adenoids out for airway obstruction, as their brain has “catch up” deep (REM) sleep, that they had previously been missing out on.