Preparing for treatment

Hospitals can be scary places, especially if you're coming in for an operation. Find out what to expect if you're preparing for treatment involving surgery at Great Ormond Street Hospital (GOSH).

Here's where you'll find information about:

Having an anaesthetic

A general anaesthetic ensures that you're not conscious and can't see, hear or feel anything during a procedure. It consists of medication given either as gases to breathe or by an injection into a vein through a thin plastic tube called a cannula.

Anaesthetists are doctors who give anaesthetics and look after children and young people before, during and after a procedure. Their role is to ensure that you're not conscious, stay safe throughout the procedure and wake up as comfortable as possible afterwards.

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Who you'll see beforehand

You'll see a member of the team during the pre-anaesthetic assessment. They will offer to see you without your parents if you want to discuss anything in private with them.

On the day of the procedure, an anaesthetist will visit you before you go to theatre and this is an ideal opportunity to ask any further questions you have about your anaesthetic. They will discuss options of anaesthesia and pain relief medication and whether you would benefit from a pre-medication (pre-med). These may already have been discussed in your pre-admission assessment appointment but it can be useful to have the conversation with the anaesthetist looking after you on the day. We want your experience to be as calm and pain free as possible.

If you become ill or are not considered well enough to have the procedure, or if you have eaten or drunk too recently, there is a chance that your procedure could be delayed or cancelled.

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Giving consent

If you're aged 16 or over it's your right to provide consent, assuming you are able. If you're under 16 you should be part of this process if you feel able. You may or may not wish to have family members or friends present to support you during this visit and we will support your wishes. 

Your wishes are very important to us and we will provide you with all the information we have from the pre-anaesthetic assessment to ensure you and/or your parents can make the best decision. It's important that you feel you have had all your questions and concerns answered before the procedure.

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Why you shouldn't eat or drink before having an anaesthetic

It's important that your stomach is empty as this reduces the risk of vomiting during the procedure, when vomit can come up the back of the throat and then get into your lungs. 

We will tell you the length of time you should be ‘nil by mouth’ – in other words, have nothing to eat or drink before the anaesthetic. However, it is important to keep well-hydrated, so you may need to wake up during the night to have a drink. 

If you take medications, carry on taking them as normal, unless your anaesthetist or surgeon has advised otherwise. For example, if you're taking aspirin, diuretics or diabetes medicines you'll need specific instructions.

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Pre-medication (‘pre-med’)

This is the name for medicines sometimes given before an anaesthetic. Some ‘pre-meds’ prepare your body for the procedure, others help you to relax. If you do need a ‘pre-med’, we'll discuss this with you beforehand. 

‘Pre-meds’ are usually liquid although occasionally an injection is needed. A local anaesthetic cream can be put on to numb the skin before a cannula is inserted – a member of staff will apply the cream if needed.

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Going for the procedure

You'll go to the anaesthetic room with your parent(s) and a member of staff. If you would prefer your parents not to go to the anaesthetic room with you, please discuss this with them beforehand. If you have something that comforts you, like a toy or game, you're welcome to take this with you.

The general anaesthetic will be given as a gas to breathe or as an injection through a cannula. You will have discussed this with the anaesthetist either at the pre-admission assessment or before you came to theatre or both. If the anaesthetic is breathed in, the anaesthetist may cup their hand over your nose and mouth or use a face-mask. Both methods work quite quickly and the next thing you will remember is waking up after the procedure.

As part of preparing for the procedure, either before or after you have had the anaesthetic, the anaesthetist will put a blood pressure cuff around your arm and a peg device on a finger or toe. Both these pieces of equipment are important for making sure you are safe during the procedure. 

Once you've had the anaesthetic, your parent(s) will be taken to your post-operative ward to wait for you to have the procedure.

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What happens afterwards

After the procedure, you'll wake up in our recovery area. The recovery nurses will call your parent(s) so that they can be with you as you wake up. 

You might feel a bit wobbly after the anaesthetic – this is normal and due to the medicines used. You can have a drink when you feel like it – small sips are better to start as you may feel a bit sick. This is also due to the medicines used. 

When you're feeling a bit better, you'll be taken to the ward to recover fully. You'll probably feel very sleepy – this is normal.

More information about after you've had an examination under anaesthetic.

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Safety of anaesthesia 

The degree of risk will depend on your medical condition and the type of surgery for which anaesthesia is being provided. You'll be able to discuss this with an anaesthetist before surgery but the following is a general overview of side effects and potential complications of anaesthesia.

Most people recover quickly and are soon back to their usual activities after an anaesthetic. Some may get side effects but these are usually mild. Headaches, nausea (feeling sick sometimes with vomiting) and a sore throat are common but can usually be treated effectively. Other side effects generally just need time to wear off and include tiredness, dizziness and disorientation on waking, which can be distressing both for you and your parents. Some people may also have disturbed sleep patterns for a few days after an operation.

More serious problems are uncommon but include a minor cut lip, damage to teeth, an allergic or other reaction to a drug and breathing difficulties either during or after an anaesthetic. People often worry about the risk of awareness during anaesthesia but fortunately this is rare. The most serious complications are usually very rare but include severe allergic reactions, nerve injury and the risk of death or disability, such as a stroke, deafness or blindness. 

Risks can't be removed completely but modern equipment, training and drugs have continued to make anaesthesia safer. An anaesthetist will be with you throughout your anaesthetic to monitor your progress and help you wake up as comfortable as possible. Other procedures that an anaesthetist may carry out, such as insertion of an arterial line, central venous line or epidural, will have their own specific side effects and risks of complication. You'll have the chance to discuss the plan for anaesthesia, its risks and how they relate to you with an anaesthetist before surgery.

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