Ask Dr. Marla: What are the risks of my child having anesthesia?
By Dr. Marla Shapiro
on March 26, 2013
My daughter has to have her
tonsils out. What are the risks
associated with “going under”?
Should I be worried?
I relate well to this question since,
despite being a doctor, I had the same worries
when my son needed a tonsillectomy! To
answer your question I turned to Dr. Jerrold
Lerman who is now Clinical Professor of
Anesthesiology at Women and Children’s
Hospital of Buffalo, but at the time, was Matt’s
anesthetist at Toronto’s SickKids Hospital.
When asked about the safety of anesthesia, he
often tells parents that they are more likely to
be struck by a car while crossing a busy major
street than experience a serious complication
during anesthesia. Today, anesthesia for
children is very safe. However, there are some
ground rules that must be followed. Here are
his tips for elective surgery:
It is most important that your child does not
eat or drink before anesthesia, according to
the instructions you were given. Not eating
reduces risk of vomiting while under.
All medical conditions, such as asthma,
should be stable and well-controlled. This
may mean a visit to your pediatrician to
adjust your child’s medications.
If your child has a cold, a fever higher than
38.5°C, change in behaviour, greenish-looking
sputum or wheezing, the anesthetist will
cancel the surgery. These signs may cause
breathing difficulties and even pneumonia
after surgery. If surgery is cancelled, it will be
rescheduled two to four weeks later.
When do tonsils need to be removed?
There are two indications for tonsillectomy:
repeated throat infections and obstructive
sleep apnea. Children with sleep apnea have
an increased risk for breathing problems after
anesthesia, particularly those with severe
sleep apnea. The risk is higher when other
conditions such as young age (younger than
three), obesity and genetic defects are present.
These children are ideally admitted overnight
after surgery to monitor their breathing and
oxygen levels. Most children have a small
amount of blood oozing from their mouths
after tonsillectomy, but this is usually not a
concern. Overall, tonsillectomy is a relatively
common surgery, which poses very little
anesthetic risk for the healthy child.