Paediatric pre-anaesthetic assessment

Pre-assessment is to ensure your child is fit for their anaesthetic and surgery. It also gives you and your child an opportunity to ask questions about the operation and to discuss what to expect on the day of surgery.

Not all patients require a pre-assessment—you will be notified of the pre-assessment date via letter or phone if it is applicable to your child.

Mastoidectomy advice

Your child is having a mastoidectomy which is an exploration of the ear and removal of any infected material to reduce the risk of possible complications associated with infection.

It is important in the run up to your operation date that your child does not have a cough, cold or any respiratory or throat infections.

Please contact the Paediatric Admissions Team on 020 3315 8018 during working hours if this occurs, as you may to need to have your operation date changed.

Day of admission

If your child is coming at 07:15am:

  • No food or milk after 02:30am and water only until 05:30am.

If your child is coming at 12pm:

  • No food or milk after 07:30am and water only until 10:30am.

Your child’s surgery may be delayed or cancelled on the day if the fasting instructions are not followed precisely.

On the day of the operation, a maximum of two adults are permitted to accompany your child—one of whom needs to be a legal guardian to sign consent. Please arrange care for siblings as we cannot accommodate them on the ward.

On arrival, the children’s nurses will prepare your child for surgery by asking if there have been any changes to their health since pre-assessment and to recheck their blood pressure etc. Ametop (local anaesthetic cream) will be applied to both hands.

All care and procedures will be explained to you and your child. You will see the surgeon who will discuss the operation with you and if you have not already done so sign a consent form. The anaesthetist will also meet you and your child.

One parent/guardian may accompany your child to the anaesthetic room.

Car parking

The rates are reduced on the operation day for your child, please ask the nurse looking after your child to arrange this.

After the operation

Initially after the operation your child will go to paediatric recovery. As soon as your child wakes you will be called to recovery. They are then transferred back to the children’s ward where their condition will be monitored and closely observed.

Children can be very miserable after waking and as the anaesthetic wears off, this is normal until your child is fully awake. Your child will be encouraged to eat and drink a normal diet once they are fully awake.

If your child needs to stay overnight, one parent/guardian may accompany him/her.

Discharge home

A mastoidectomy can be a painful procedure. This pain can last for up to two weeks. The pain may get worse before it gets better (usually from days 4–7) and you may find they complain of earache.

Please keep the ear dry until you have had a follow-up appointment with the surgeon.

  • Avoid sudden head movements
  • Avoid playing sport and exercise
  • Avoid straining and lifting heavy weights
  • Avoid nose blowing.

It is advisable to treat the pain before it builds up—therefore give medicine prescribed regularly for the first week. During the second week give pain relief medicine as required.

We advise you wait 10–14 days before your child returns to school/nursery. This is because they are susceptible to any infection during this time. They need to be kept away from crowds and people with coughs and colds during this time.

If you child becomes unwell or has a high temperature above 37.5°C, please contact your GP. If you have any concerns out of normal working hours, please contact your local A&E Department.


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