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Anesthetic
considerations for children are different from those for adults. This
means that the anesthesia care team demonstrates sensitivity to the
needs of children and their parents and utilize strategies to help
reduce fears and anxieties.
If the family is unable
to bring the child for a visit prior to the day of surgery, one of our
preop nurses will contact the family to gather information about the
child's medical history. The day of surgery, one of the
anesthesiologists will visit with the patient and family to review the
history, assess any changes in status and discuss the proposed
anesthetic plan in words that children can understand. An anesthetic
consent will be obtained once any questions that arise have been
answered. Appropriate sedative medications can then be ordered to be
given by mouth, IV or by injection. Most commonly they are by mouth
and, if a liquid, will be mixed with a flavoring agent to improve the
taste.
When the operating room
and surgeon are ready for the patient, he or she will be directly
transported to the OR. The most frequent method of induction for a
small child is by breathing anesthetic gases through a scented, clear
plastic mask. Older children and teens often undergo induction after
placement of an IV because it is faster and easier for them. However,
if the child is afraid of needles, a combination of nitrous oxide
(laughing gas) and local anesthetic can make the IV experience more
pleasant. One of the anesthesia care team (either nurse anesthetist or
anesthesiologist) will remain with the child throughout the operation,
monitoring the vital signs and continuing the anesthetic.
At the conclusion of the
surgery, the child will be transported to the postanesthetic care unit.
Once he or she has recovered adequately, the child will be returned to
the parents. Pain medication as well as antinausea agents are given as
appropriate to manage patient comfort.
Once the child is fully
awake and is able to drink fluids, the patient should be able to be
discharged. Children and teens generally recover quickly from surgery
and anesthesia; however, if issues arise after discharge, please do not
hesitate to contact the surgeon or the anesthesia department to discuss
these.
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