As parents ourselves, we know that surgery for your child is a very stressful time. Good information about the process of surgery and anesthesia will help reduce your anxiety. A calm and knowledgeable parent will help enormously to make this experience a positive one. The following information is arranged in a series of answers to commonly asked questions about anesthesia.

Who will administer anesthesia to my child?
Your child will typically receive anesthesia from a team consisting of an anesthesiologist and a nurse anesthetist (CRNA). An anesthesiologist is a physician who has completed 4 years of medical school and at least 4 years of additional training in anesthesiology. A CRNA is a graduate from an accredited school of nurse anesthesia and works under the supervision and medical direction of an anesthesiologist. The anesthesiologist is the physician responsible for the safety and comfort of your child during surgery. He or she will be responsible for diagnosing and treating any medical problems during the anesthetic.
Each child is treated with extreme care under anesthesia, no matter what the surgical procedure. Changes in blood pressure, heart rate and breathing can occur rapidly in children and may require rapid treatment. Both the anesthesiologist and CRNA will try to make your child as comfortable as possible around the time of his surgery. They understand how frightened a child may be during time in hospital. Your anesthesiologist may also be asked to provide sedation or anesthesia for your child undergoing a variety of procedures in the hospital, such as an MRI of CAT scan. The Anesthesiologist can also help provide pain relief for your child after surgery.

As a parent, what can I do to help?
Prepare your child for surgery. Try to allay any fears your child may have about what is going to happen in hospital. The best way to reduce your child’s anxiety is to explain the various events which will happen to him in the hospital. It is important to be honest with your child. Encourage them to ask questions. They will meet many unfamiliar doctors and nurses, but these people are kind and friendly and are there to help them. They should expect to have to be separated from you for a brief period during the operation but that you will be close by and will be with them right after the procedure as they awaken in the recovery area. You should also say that they may experience some discomfort after the operation, but that the doctors and nurses will give medication to make it better.

What will the anesthesiologist need to know?
Your anesthesiologist will ask you a series of questions to prepare a safe plan for your child’s anesthesia. It is important that your child be in the best possible condition prior to surgery. Recent colds and chest infections, for example, can produce unwanted respiratory difficulties during anesthesia, so it may be safer to postpone elective surgery in these circumstances. You will be asked questions about any medical conditions or previous surgeries your child may have had, or if there is a family history of problems with anesthesia. Your anesthesiologist will now be in a position to outline the plan for anesthesia, including the period before surgery and in the recovery area afterwards. This is the best time for both you and your child to ask questions and express your concerns.

Will my child be given some sedation before surgery?
The anesthesiologist will determine, depending on the type of surgery, the child’s age, general condition and level of anxiety, whether premedication is required prior to surgery. A well-prepared child may be calm and require no preoperative sedation. Occasionally, however, a child may require medication and a small amount of sedative can be administered by mouth. Versed is the most commonly used drug for this purpose since it is both rapidly acting and of short duration. This drug often produces amnesia for the period leading up to surgery and children may have no recollection of the journey to the operating room.

How will my child be put to sleep?
Most children under the age of 10 years are put to sleep by breathing anesthesia gases through a mask. Your child is taken to the operating room, monitors for heart and breathing are placed and a scented plastic breathing mask is placed over your child’s nose and mouth. A mixture of anesthesia gases is inhaled and the patient is usually asleep within 10 breaths. Minor surgeries such as ear tubes, may be performed without an IV However, in the majority of surgeries, an intravenous is started once the child is asleep.

What is a Caudal Block?
A Caudal Block is an injection performed in the tailbone to numb the nerves in the lower half of the body. It is like an epidural where local anesthetic medication is placed very close to the nerves before they enter the spinal cord. It is performed after the child has been put to sleep. The child is turned on his side and the skin over the lower part of his tailbone is prepped with a sterile solution and a small needle is placed in between the sacral vertebrae. Numbing medication is then injected. The resulting anesthesia usually allows a major reduction in the amount of other anesthesia medications, so the child often wakes up quickly and comfortably after the surgery. While risks include infection, bleeding or nerve damage, these risks are very small and this is considered a very safe and effective pain relieving technique.

What will my child get for pain relief after surgery?
If your child is having outpatient surgery, we will make sure that pain relievers by mouth will be sufficient to keep him or her comfortable. If your child is admitted to the hospital after surgery, we will consider giving pain relievers through the IV. Assessing your child’s pain is a routine part of hospital care and the nurses employ a variety of methods to do this. Perhaps the most common is to have the child choose how he or she feels by pointing to a face in a series ranging from smiling to severe pain. Pain relief is important to your child’s recovery, so your anesthesiologist will describe the options available and will recommend the best options for your child.

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