Risks of having anaesthetic

For more information about anaesthetic risks, please see the Royal College of Anaesthetists (RCoA) infographic here.

The following information below provides more detail about the side effects and risks associated with general anaesthesia in children.

Common side effects of general anaesthesia

Common side effects of general anaesthesia include:

• sore throat
• feeling sick or being sick
• feeling dizzy
• feeling confused
• feeling agitated
• having a headache
• feeling some pain

These side effects are common, affecting between 10 and 20 of 100 children.

Are there any serious risks associated with my child’s anaesthetic?

It is rare for serious complications to happen.

All of our anaesthetists are experienced at dealing with these complications and the vast majority of children go on to recover fully. This information can be difficult to read and feel frightening or overwhelming. Please try not to worry.

To try and put things into perspective please consider that we take risks every day that we do not worry about too much, for example driving a car.

Breathing problems

A general anaesthetic can lead to problems with breathing, affecting the voice box or breathing tubes in the lungs.

This can cause low oxygen levels, which can be harmful if not corrected quickly. A large study of complications of anaesthesia in children reported 240 episodes of breathing complications for every 10,000 anaesthetics.

Most of these breathing problems can be treated quickly and have no lasting consequences but rarely they can require admission to intensive care or even lead to death or permanent injury.

Breathing problems are more common in children with coughs and colds.

Aspiration of stomach juices

During anaesthesia it is possible for food or liquid in a child’s stomach to come up the food pipe and enter the lungs. This can cause damage to lungs and lead to infection.

It is very rare, with a study finding that it happened to 9 in 10,000 children under anaesthetics.

You should not let your child eat or drink anything before general anaesthesia to reduce this risk.

Complications of airway management

When someone is under general anaesthesia, the anaesthetist will make sure their breathing tubes are not blocked and that the lungs can get oxygen.

Very rarely this can be difficult and in extreme circumstances oxygen levels can drop and lead to harm or even cardiac arrest. Anaesthetists are trained to deal with this complication and very rarely are required to make a small hole in the windpipe at the front of the neck to save a someone’s life.

Heart problems

These are very uncommon in healthy children.

Occasionally general anaesthesia can lead to an unusually slow or unusually fast heart rate or a low blood pressure. This is usually easily treated.

Allergic reaction

Allergic reactions can occur to various substances including medicines, latex or the cleaning solutions used on the skin. They are often mild reactions but can be life threatening. The risk is estimated as 2 to 3 reactions per 100,000 anaesthetics.

Awareness

This is the situation when a someone under anaesthesia has some recollection of events when they were supposed to be asleep. This is extremely rare, and a large audit found 1 to 2 reports of awareness in children per 100,000 anaesthetics. Anaesthetists constantly monitor how much anaesthetic is being given and will be looking for any signs of this.

Medication errors and equipment failure

It is possible to make mistakes when giving medicines. The wrong medicine may be given or the wrong dose of a medicine may be given. It is also possible for a medicine to be given by the wrong route, for instance a local anaesthetic could be given into a vein. The outcome of this can vary from no harm to life threatening. The risk of this happening is 5 errors per 10,000 anaesthetics.

During an anaesthetic medicines are given via small plastic tubes called cannulas. It is possible for cannulas to become misplaced and for medicines given through a misplaced cannula to cause injury.

All essential equipment is checked on a daily basis but it is still possible for these to malfunction.

Injuries during surgery and anaesthesia

Very rarely it is possible for people having anaesthesia to have significant injuries to:

• their eyes
• their lips
• their tongues
• their voice boxes
• their teeth to be damaged

Nerves can be stretched and damaged during positioning although great care is taken to prevent this from happening. There is a risk of pressure sores especially with longer procedures.

Complications from peripheral nerve block

A nerve block is the injection of local anaesthetic around a nerve to numb the nerve. This is often done as well as a general anaesthetic in order to provide pain relief post operatively. The risks of having a nerve block include nerve damage. This can be caused by injury:

• from the needle
• a blood clot
• infection
• toxic effects of the drug injected

Usually any nerve damage is temporary. The risk of permanent nerve damage is rare and estimated to be between 1 in 2000 and 1 in 5000 nerve blocks.

Death, cardiac arrest and unplanned admission to intensive care

Overall, for every million anaesthetics given, about 10 people die as a result of a complication of the anaesthetic. This includes people of all ages, including the very elderly.

Cardiac arrest happens when the heart stops pumping blood to the body which happens in around 3 out of every 10,000 anaesthetics.

Most children recovered without injury. Children who experience a complication of anaesthesia may be admitted to intensive care for further treatment. The risk of this occurring is 1 in 10,000 anaesthetics.