FAQ

Children aren't just small adults. They can't always say what's bothering them or answer medical questions. And it's very hard for them to be patient and cooperative during a medical procedure or examination. Pediatric anesthesiologists know how to examine and treat children in a way that makes them relaxed and cooperative. In addition, pediatric anesthesiologists use equipment and facilities specifically designed for children.

Pediatric anesthesiologists are anesthesiologists with a special interest in children and/or special training in pediatrics. Most anesthesiologists will go to college for four years, medical school for four years, and then do an internship and residency for four years. Pediatric anesthesiologists may have also done a pediatrics residency or an additional pediatric anesthesiology fellowship. All of the physicians on the ARCh team are board certified/eligible and fellowship trained in pediatric anesthesia.

Effective anesthesia plays a big role in how quickly your child recovers and feels good again. One of the main benefits comes from controlling the body's stress response to pain and trauma. By monitoring and controlling blood sugar and the levels of cortisol, epinephrine and other stress hormones, we can improve recovery time and reduce the risk of post-operative infection, kidney failure and death.

In most cases, we give children an oral anti-anxiety medication before we begin. Our nurses call it "happy juice," and it makes the child more relaxed and comfortable.

When we're ready to begin, we usually ask the child to breathe anesthetic gasses through a mask.

If an intravenous line is needed, we usually place it after the patient is asleep. Our experience and training enable us to handle IVs in a smooth and non-threatening way. We also place the breathing tube after the child is asleep. When the surgery or procedure is finished, we take the breathing tube out and move the child to recovery with the IV in place. This enables us to provide additional medication or fluids if needed without an additional needle.

We monitor a range of critical indicators, including brain function, blood composition, oxygen levels, hormone levels and more. This non-invasive monitoring enables us to keep the patient asleep and healthy throughout the procedure. We can maximize protection of the body's organs and improve recovery time by controlling the natural stress response to pain.

Pain control is our number-one priority. We use intravenous or oral pain-relieving medications, as well as a variety of innovative techniques including caudal, epidural, and peripheral nerve blocks. We'll be glad to discuss the options with you in more detail.

You won't be able to be in the recovery room when your child first awakens, but a nurse will be by his/her side. We'll bring you in quickly—usually before your child is fully aware of his/her surroundings.

After the anesthesia, your child may experience nausea and vomiting or agitation. These are common side effects that we can deal with easily. In almost every case, we give medications to prevent post-op nausea and vomiting.

It's often hard to predict how sedated or sleepy a child will be. Depending on the medication used and the child's response, some children may be awake at the end of the procedure and be ready to go home once specific discharge criteria are met. With today’s advanced anesthesia medications, most patients wake up in 10 minutes and are fully aware in 20 minutes.

Some children may continue to need monitoring and observation in the recovery room until they're awake. Most children are able to resume normal, quiet activity within a few hours after the procedure.

Depending on the sedative medication used, children may continue to be sleepy and unsteady on their feet for a few hours after the procedure. We recommend that you observe your child in the car seat during the ride home. In addition, a responsible adult should stay with the child for 12 to 24 hours after sedation. It's smart to delay activities that need coordination, like swimming, use of playground equipment, climbing, riding a bike, roller-blading or skating for 12-24 hours, until you're sure the child is stable and alert.

When it isn't contraindicated by the surgery, we start children on clear liquids—water, Pedialyte, Popsicles—in the recovery room. In most cases, children can eat solid foods within two to four hours after the procedure if their appetite has returned and there's no lingering nausea.

It's not uncommon for children to have motion sickness in the car on the way home even if they've felt OK in the recovery room. Plan to bring along an extra towel or moistened wipes.

While children are in the recovery room, we administer enough pain-control medication to keep them comfortable during the first one or two hours. If they're staying overnight in the hospital, we'll provide something longer lasting that will diminish pain for three to six hours. The surgeon will write additional orders for medication to control breakthrough pain after this initial period.

The specific risks of anesthesia vary with the type of operation and whether it's an emergency, the age of the child, and any other problems or illnesses that exist. In addition, each type of anesthetic has a specific set of risks and side effects. We'll talk with you about the advantages and disadvantages of the various types of anesthesia that are options for your child. The risks of anesthesia fall into two categories—side effects and adverse effects.

• Side effects. A side effect is a secondary or unwanted effect of a drug or treatment. Many side effects of anesthesia drugs and techniques can be anticipated, but may be unavoidable. Although at times uncomfortable or distressing, most common side effects are not particularly dangerous. They'll either wear off or can be treated easily. Examples of side effects are nausea, vomiting, drowsiness, dizziness, sore throat, shivering, aches and pains, discomfort during injection of drugs, and agitation upon awakening from anesthesia.

• Adverse effects. An adverse effect is a result of a drug or treatment that is neither intended nor expected. Adverse effects are very rare, but may occur. These may include dental trauma, croup (swelling of the windpipe), allergic reactions to drugs or latex products, wheezing, vocal cord spasm or injury, regurgitation of stomach contents with subsequent aspiration pneumonia, injury to arteries, veins or nerves, alterations in blood pressure, and/or irregular heart rhythms. Death and brain damage are the most feared of all anesthetic risks, but fortunately these complications are extremely rare.

Here are some important steps you can take to reduce anesthesia risks:

• Share all information about your child's health (including any drug allergies and current prescription and non-prescription medications) with the anesthesiologist prior to the procedure. This will allow the anesthesiologist to choose anesthesia and drugs that are safest for your child.

• Adhere to the guidelines you're given about limiting eating and drinking before the operation

• Continue your child's usual medications unless your anesthesiologist or surgeon recommends against it

• Ensure that any other chronic illnesses are being optimally treated
• Have an anesthesiologist who is experienced in the care of children

Most children who undergo anesthesia will be quite comfortable and have no complications. They'll often be able to go home the same day if the surgery isn't too extensive.

Like other medical specialists, anesthesia charges are separate from facility and surgeon fees. If you have any questions about your insurance plan, or anesthesia bill, please contact our office at 972-934-5220.