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| Examination Under Anaesthesia |
EUA stands for Examination Under Anaesthesia. It is a standard outpatient procedure in the management of children with retinoblastoma. A short acting general anaesthetic will be given to your child to allow a thorough exam of both eyes. Although the EUA takes place in Theatre (operating room), it is not itself a surgical procedure. Any necessary surgical procedures will only be performed after they have been discussed with you and you have given your consent. Due to the young age of children diagnosed with retinoblastoma, and the location of the retina at the back of the eye, thorough eye exams in the office setting are not a possibility. An Examination Under Anaesthetic (EUA) is therefore the best method of properly examining your child's eyes, Eating before an EUA can cause dangerous complications during the general anaesthetic, so your child will not be allowed to eat solid foods for at least 8 hours before the exam. Clear liquids such as apple, grape, cranberry juice and cordial or water (NOT milk or orange juice) may be given up to 6 hours before surgery, but after that, food and drink must be withheld. Your hospital will give specific instructions. Withholding food is extremely important, but can be particularly hard for small children. However, some simple steps can be taken to reduce the stress on both sides. Don't eat or drink whilst in the company of your child Do provide some favourite activities to divert attention away from thoughts of food (so obviously avoid items such as picture books about food). If your child is old enough, you could discuss a favourite meal he can have as a post-EUA reward for good behaviour. Remember that giving reasons for not allowing food will help your child understand what is going on. Before the EUA, the anaesthetist will examine your child and ask you a serise of questions to confirm that he is fit and well enough to cope with anaesthetic. If your child has a cold or other seemingly mild illness, the EUA may be postponed until he is recovered. Eye drops are necessary to dilate the pupil, and these will be given before the anaesthetic is administered. The eye drops will sting for up to 30 seconds, and may cause your child some distress for a short time. Wherever possible, try to hold your child still and give reassurance while the nurse gives the eye drops. If he is old enough to understand, explain that there will be some stinging, but it will go away very quickly. Once your child has been cleared for anaesthetic, he will be given a mild sedative injection, usually in the thigh, approximately 10 minutes before being taken to Theatre. The anaesthetist will administer the anaesthetic drugs in Theatre. There are three ways in which this can be done: Mask: this is the standard approach for babies and very young children. The mask is placed over the mouth or nose, and the drugs are inhaled. IV injection: this route can be used if your child already has an IV canula inserted. Older children may prefer to let the anaesthetist insert a canula as this may be less distressing for them. If the IV option fails, it is always possible to use the mask. Port access: if your child has a port (used for chemotherapy), it may be possible to use it for anaesthetic administration. Discuss this with the anaesthetist when you are on the ward. The nurses will usually be able to access the port in preparation for its use. Your presence may be particularly therapeutic if your child is very young or distressed. Many hospitals will allow you to remain with your child until he is asleep, though some will only allow you as far as the Theatre anti-room. Some hospitals have set procedures whilst at others, such decisions rest with the attending physicians. You should discuss the options with the anaesthetist. During the EUA, your child's breathing and heart rate will be closely monitored by the anaesthetist, and he may be intubated to manage breathing. This involves inserting a flexible tube into the throat, and it will be removed once the procedure is complete. The EUA itself is likely to involve the following procedures: - External and internal examination of both eyes - Ultrasound - Treatments to the tumour(s), such as cryotherapy or laser. - Photographs of both eyes and drawings of the affected eye(s) An average EUA may last about 45minutes, after which your child will be taken to Recovery until he is fully conscious. Your child's physician will be able to give you an idea of the time-scale before the exam. Upon waking, some children experience confusion, irritability and/or distress. Though this is normal, certain anaesthetic agents may cause or amplify the symptoms and you should discuss any potential effects of individual drugs with the anaesthetist before administration. Although your child may cry, it is unlikely that he is experiencing any physical pain. Strange as it may sound, crying is thought to aid the removal of remaining anaesthesia from the body and thus speed up the recovery process. Drowsiness may remain after an EUA. If your child does sleep, this is likely to last for about an hour, and is totally normal. Your child may wake up feeling hungry, particularly if the EUA has been delayed. It is usually preferable to begin with clear liquids and build up from there. It may be a good idea to bring your child's favourite drink as a treat. Infants may be given breast milk as usual. Your child will usually be ready to go home several hours after the EUA. However, any necessary eye surgery may require an overnight stay. The doctor will usually discuss the findings of your child's EUA before you leave the hospital, and will tell you when to return for a clinic appointment. Before you leave the hospital, be sure that you are happy with your child's physical and mental wellbeing. If you have any doubts, discuss them with your child's nurse or doctor. - What time is the EUA scheduled? - Who will perform my child's exam? - What procedures will be carried out during the exam, and why? - How long is the exam likely to last? - When will we discuss the outcome of the exam? - What anaesthetic agents will be used? - What are the side effects of these drugs? - What method will be used to administer the anaesthetic? - Can my child's port be accessed for the anaesthetic? - Can I say with my child until he is asleep? - What monitoring equipment will you use during the EUA? - How long will it take for the anaesthetic to wear off? Last updated: 20th March 2004. Go back to ORbIT Treatment index. |
| ORPHANS OF THE CANCER STORM |
| Disclaimer This information page has been prepared by an individual who does not have medical training. However its contents have been reviewed by appropriately qualified medical professionals for accuracy and quality. This page is intended for information purposes only and should not be used as a guide to diagnosis or treatment. If this information raises any concerns about your child’s condition or care protocol, discuss them with his or her paediatrician, oncologist, or other appropriate medical professional who has knowledge of the case. |