What to Expect Immediately After Pediatric Surgery

After surgery, your child will go to the recovery room, also called the post-anesthesia care unit (PACU). The PACU staff will bring you to this room when your child is stable. For health and safety reasons, the number of parents or caregivers who can be with a child while in the PACU is limited. Please see our Visitation Guidelines page for up-to-date information about who may visit.

Below is some information created by the Family Teaching Program at The Bristol-Myers Squibb Children's Hospital to help you understand what to expect immediately after your child's surgery is over.

While your child is in the PACU, nurses will watch them closely as they start to wake up.

The nurse will check:

  • Vital signs: blood pressure, pulse, breathing and temperature
  • Any signs of problems
  • Child's level of consciousness
  • Surgical/procedure site
  • IVs, tubes or drains, if they have any
  • Child's urine output
  • Child's pain levels; will treat with medicine and body positioning
  • Whether your child is awake enough to swallow well before offering something to drink

After surgery your child may:

  • Look puffy or swollen
  • Look pale
  • Be shivering (even though their temperature is normal)
  • Have an intravenous line (IV) to deliver fluid and medicine
  • Have monitors attached to them
  • Be receiving oxygen by mask, tube or nasal prong
  • Have an oral airway (a plastic piece in their mouth protecting their breathing)
  • Have a nasal airway (a rubber tube in their nose protecting their breathing)

If you have questions or concerns about anything you see, please ask your child’s nurse.

Common Side Effects of Surgery and Anesthesia

Common side effects of surgery and anesthesia may include:

  • Nausea and vomiting
  • Pain, soreness and swelling around the surgical incision site
  • Funny taste in mouth
  • Restlessness and sleeplessness
  • Fussy or confused
  • Dry mouth, sore throat, hoarse voice
  • Sore muscles
  • Blurred vision
  • Short–term memory loss
  • Mood changes or crankiness
  • Facial redness or flushing
  • Dizziness, especially the first time out of bed

Waking Up

It's important to remember that each child wakes up differently. Some are wide awake in the PACU. Others are groggy for hours. Some are very confused and may be agitated for up to an hour after the surgery.

Many children, especially those under 6, experience what doctors call "emergence delirium." They appear to be awake, but aren't really aware. During this time, a child may cry, thrash and reach for his parent, and nothing seems to calm them. If this happens to your child, it can be upsetting, but remember that it usually goes away by itself. It just takes time for the effects of anesthesia to wear off, going back to sleep sometimes helps. Your child's nurse will make sure that your child is safe. In the meantime, try to stay calm and comfort your child. They won't remember this excited state and will most likely wake up later feeling fine.

What Can You Do for Your Child in the Recovery Room?

Seeing your child in the PACU can be difficult. While you wait for them to wake up you may feel anxious or helpless. Here are a few things you can do to help your child and the PACU staff:

  • If your child is sleeping, do not wake them up.
  • Speak softly and calmly. Reassure your child.
  • Respect the privacy of other patients and focus on your child.
  • Do not take pictures or videos.
  • Follow all staff instructions. Sometimes, if there's an emergency on the unit, they may ask you to temporarily leave the room.

Ready for Discharge

The length of time your child spends in the PACU depends on the type of surgery they had and their response to surgery and anesthesia, as well as their medical condition.

Once your child is fully awake and vital signs (blood pressure, pulse and breathing) are stable you will be able to leave the PACU. Your child’s surgeon and anesthesiologist will decide whether an overnight admission is necessary. If your child is going home, your nurse will give you follow-up care instructions; otherwise, your child will be admitted to a hospital room.

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