Despite parents and patients being counseled before the surgery to help them cope with the upcoming surgery of their child ,the phase of preparation for the surgery, the time of the surgery itself, and the recovery period (Post-surgical period) can be a stressful and trying time for the child and the family.
All children are admitted into the paediatric ward which has dedicated nurses all of whom are trained and aligned towards the management of children. Children undergoing major surgery are usually monitored in the Intensive Care Unit (ICU) for a period of 24-48 hours post operatively. The ward itself is equipped with advanced patient monitoring devices and all the necessary equipment required for the child’s smooth recovery.
Parents are encouraged to participate in the management of the child and to spend as much time as possible with their recuperating child. For children undergoing major surgery and reconstructive procedures the exact length of stay in hospital following surgery is hard to determine and is very variable. It varies depending on the complexity of the procedure, and above all the recovery and progress of the child. It is of immense help when parents are cooperative and encourage the child, as it leads to faster recovery.
Pain control is our top priority and starts at the time of the surgery itself. All operative wounds are infiltrated with a local anaesthetic to ensure the child is comfortable upon waking up from the procedure. Major cases are always accompanied by a Morphine infusion which is usually continued for a period of 24 to 72 hours before being tapered down. The patient is also given paracetamol or slightly stronger analgesics to further help them remain pain free. Being pain free increases the confidence of the child and encourages earlier ambulation and faster recovery.
Allowing the child drinks and food following surgery is the other major priority. The commencement of this process depends on the operative procedure performed and can vary on a case to case basis. The intestines become lazy following major abdominal surgery and it is wise to wait till they start functioning reasonably before allowing normal fluid intake. The surgeon will advise you appropriately, and once the child is able to tolerate some clear fluids initially they are then gradually promoted to nourishing fluids and then on to a soft diet. All children following major surgery are always on an infusion of intravenous fluids to keep them hydrated. Depending on the surgeon’s instructions children are often allowed ice lollies, a sweet or lollipop to suck on, which usually keeps them cheerful.
As mentioned before Day Surgical Cases as the name suggests are allowed home on the same day of surgery unless they suffer untoward side effects of the anaesthesia like vomiting, headaches and dizziness which is a very rare occurrence in this day and age.
In general children recover very well, even after the most major surgery. This is further made easier by our advanced nursing care, ambience of the ward, and guidance from the Paediatric surgeon at all times following the surgery. The parents being involved in the joint management of the patient is of immense help and provides a moral boost to the child and a faster recovery.