10 Questions to Ask Your Child’s Anesthesiologist

By Dr. Eric Ontiveros,  chair of pediatric anesthesiology at CHOC Children’s

You want to know your child who needs surgery is in the best hands. Kids’ bodies are completely different inside, and pediatric specialists know the difference. Pediatric anesthesiologists at CHOC Children’s, who lead your child’s surgery team, have compiled a list of questions commonly asked before surgery. Any question about your child is a good question. If there is ever anything you do not understand, ask your child’s surgery team.  They are there to help.

Am I allowed to be with my child before surgery? If so, for how long?

Before surgery, you and your child will be taken to the pre-operative unit, or “pre-op.”  A nurse will review the information needed to safely perform the child’s procedure. The surgeon and the anesthesiologist will evaluate your child and answer any questions you have. You will be asked to sign any necessary paperwork and then accompany the child to the operating room doors. After another hug and kiss, the team will assume care of your child.

Am I allowed to be with my child while anesthesia is being given?

You child’s safety is our biggest priority. Having a parent in the operating room can distract the team’s focus away from your child. To ensure the safest environment possible for your child, you will be taken to the waiting room.

Will my child have pain when getting an IV?

Depending on the child’s age and planned procedure, we may start an IV in the pre-op unit. An IV is a small plastic tube inserted into the vein and  used to deliver medication. Depending on the age of your child, a small amount of anti-anxiety medicine may be given orally before placement of the IV. The staff will also use special numbing medicine to reduce the discomfort of IV insertion. A child life specialist will provide age-appropriate distractions such as books, games, or bubbles to aid in the process.

What kind of anesthesia will my child be given?

Anesthesia is broken down into three main categories: General, Regional, and Local.

General anesthesia makes and keeps a person completely unconscious (or “asleep”) during the operation. It can be administered through an IV, or by inhaling an anesthesia gas delivered by mask.

Regional anesthesia is when a drug is injected near the spinal cord, numbing a large area of the body. An example is an epidural. It is often combined with general anesthesia in kids and used for pain control after the surgery.

Local anesthesia numbs a small, specific area of the body- for example, a foot, hand or patch of skin. It can be given as a shot, spray or ointment. Local anesthesia is often used to reduce the pain after surgery.

The anesthesia your child receives is tailored to their needs and depends on factors including:

  • The type of surgery
  • The location of the surgery (hospital, outpatient surgery center or doctor’s office)
  • How long the surgery will take
  • Current and previous medical condition
  • Previous reactions to anesthesia (in your child or family members)
  • Medications your child is currently taking
  • Age, height and weight

No matter which type of anesthesia your child receives, your anesthesiologist will be available before, during and after the operation to monitor the medications your child receives and ensure they are receiving the right amounts.

Will my child be sedated before anesthesia is given?

Your child may receive medication to help them remain calm and feel sleepy before the procedure or surgery. This medication is usually given by mouth and before starting the IV. Many children are curious about the operating room and prefer to experience falling asleep in the OR, so they skip the sedative.

Will my child still have an IV in or be hooked up to any monitors or equipment after surgery is over?

Your child will usually wake up with their IV in place. This is helpful as additional medications are sometimes needed to treat pain or nausea. Your child will also wake up with several monitors that help the anesthesiologists and nurses monitor your child’s recovery from anesthesia. These monitor blood pressure, heart rate and oxygen levels. As your child recovers from anesthesia, the IV and monitors will be removed.

How long will it take my child to fully wake up from general anesthesia?

The anesthesiologist will begin to “wake up” your child after the surgery is completed. This amount of time varies from child to child and is dependent on their medical history and type of surgery performed. This can take up to an hour, and most children wake up in the recovery room (also referred to as the post anesthesia care unit, or PACU) in a shorter amount of time. Full recovery can take up to several hours.

How soon after the surgery can I see my child?

After the surgery is completed, the surgeon will speak with you in the Tidwell Procedure Center lobby. It may take an additional 20 to 30 minutes for the nursing staff and anesthesiologist to recover your child from anesthesia before having you enter the recovery room (PACU).

How soon after the surgery can my child eat, drink, go to school, or drive [if you have a teen]?

If your child is going home after surgery, the nurse will offer your child a snack and drink in the recovery room. No driving for teens the day of surgery. The surgeon will provide a school note if time off is required. If a hospital stay is required, and depending on the procedure, the surgeon will order the appropriate diet.

How soon after the surgery can my child go home?

Children usually spend 30-90 minutes in the recovery room. Patients heading home will be provided a discharge plan. This plan may include instructions on how to take care of the operative site, what medications to take, what your child should eat that day, and what activities the child may participate in. It will also have instructions on what to look out for and when to call the doctor. Download a copy of the discharge questions worksheet.

You will receive a phone call from a CHOC nurse within 72 hours of the patient’s discharge from the hospital. Our nurse will ask about how the child is feeling and will be able to answer any additional questions you may have.

Download these questions and answers.

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7 Things You Didn’t Know about Pediatric Anesthesia

By Dr. Eric Ontiveros,  chair of pediatric anesthesiology at CHOC Children’s

Finding out that your child needs surgery can be scary for parents to hear. You want to know that your child is in the best hands possible, and the nationally ranked surgeons and pediatric anesthesiologists at CHOC Children’s specialize in the care of kids. Your child’s pediatric anesthesiologist is not only an important member of your child’s surgery team but also the entire perioperative experience (before, during, and after surgery).

7 things you may not know about pediatric anesthesia:

  1. Before surgery, the preoperative area is the location where you will meet your child’s full surgical team. During this time, questions about your child’s medical and surgical history will be asked and the perioperative plan is adjusted to fit your child’s medical needs.
  2. It is normal for children to feel anxious before surgery. Premedication for anxiety may be administered, either orally or intravenously prior to surgery. This may require the help of a parent. The goal of premedication is to reduce the anxiety and facilitate a smoother transition to general anesthesia. Evidence shows that easing a child’s anxiety prior to heading into surgery may limit the emotional disturbances felt during recovery after surgery. Child life specialists are also available, and may use distraction, video or music therapy to calm an anxious patient.
  3. Anesthesiologists will use a multimodal approach to pain management when appropriate. In addition to pain management during surgery and in the recovery room, a particular child and surgery may qualify for a regional anesthesia procedure or “pain block” that will help control postoperative pain during the days following surgery.
  4. For younger children who meet specified criteria, an inhalational technique may be used to initiate general anesthesia. This technique administers anesthesia through a mask (with a flavor of your child’s choosing) and avoids the placement of an IV until after your child is asleep. For older children, an IV may be placed in the preoperative area after receiving anti-anxiety medicine in oral form.  This allows general anesthesia to be administered in IV form.
  5. You know you’re not supposed to eat or drink anything before surgery. But do you know why? When general anesthesia is administered, your muscles relax, including the muscles in your stomach and esophagus. The body’s reflex to swallow is also briefly suspended during anesthesia. This combination makes the lungs vulnerable to aspiration of food, which can be very dangerous. Abstaining from food for 8 hours prior to surgery is very important for the safety of anesthesia for your children.
  6. Common side effects of general anesthesia include nausea, vomiting, itchiness and something called emergence delirium. Emergence delirium lasts 5-15 minutes and happens during the process of waking up. It usually goes away on its own but can be very concerning for parents because your child may not recognize or respond to you. If your child experiences any of these symptoms after a procedure, their care team will be available to provide appropriate medication to treat those side effects.
  7. Difficulty sleeping may occur for a few nights after a surgical procedure. Night terrors are a common occurrence in children ages 3-6 who have had ear, nose and throat procedures. This difficulty sleeping is often troubling for parents but will typically resolve after a few days and requires no additional treatment. Maintaining a consistent bedtime routine as well as eliminating sources that may interfere with sleep (caffeine, sugar, high energy activities and electronics before bedtime) may help in dealing with these disturbances.

The more information you have, the calmer you and your child will be prior to surgery. Parents are encouraged to ask as many questions as possible when you meet their child’s anesthesiologist, before or after surgery.

In the video below, a pediatric general and thoracic surgeon answers parents’ most common questions about surgery and anesthesia:

Video: Get answers about anesthesia

 

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