When a child undergoes surgery, some form of anesthesia is administered for the relief of pain and sensation during surgery. General anesthesia is also used in tests and procedures that require a child to stay still, such as an MRI, which can last one - two hours long.
The anesthesiologist is involved in all three phases of your child's care: before, during and after.
Statement on the Use of Anesthetic Agents in Newborns & Infants
Recent animal studies suggest some anesthetic agents may be harmful to the developing brain; however, the relevance of these findings to human newborns and infants is unknown. Phoenix Children’s Hospital and Valley Anesthesia Consultants, Ltd., endorse a December 2012 statement from SmartTots, a research initiative of the International Anesthesia Research Society, that directly addresses this issue. The consensus statement has also been endorsed by the United States Food and Drug Administration, American Academy of Pediatrics, Society for Pediatric Anesthesia, and other related organizations.
Types of Anesthesia
During surgery, your child will be given some form of anesthesia--medication administered for the relief of pain and sensation during surgery. The type and dosage of anesthesia is administered by the anesthesiologist. When your child is scheduled for surgery, you and your child will meet with the anesthesiologist or nurse anesthetist before the procedure. The anesthesiologist will review your child's medical condition and history to plan the appropriate anesthetic for surgery.
There are various forms of anesthesia. The type of anesthesia your child will receive will depend on the type of surgery and your child's medical condition. Usually, an anesthesiologist or nurse anesthetist will administer a sedative to make your child sleepy, in addition to the anesthetic. The different types of anesthesia include the following:
Local anesthesia - Local anesthesia is an anesthetic agent given to temporarily stop the sense of pain in a particular area of the body. A patient remains conscious during a local anesthetic. For minor surgery, a local anesthetic can be administered via injection to the site. However, when a large area needs to be numbed, or if a local anesthetic injection will not penetrate deep enough, physicians or nurse anesthetists may use regional anesthetics.
Regional anesthesia - Regional anesthesia is used to numb only the portion of the body which will receive the surgical procedure. Usually an injection of local anesthetic is given in the area of nerves that provide feeling to that part of the body. There are several forms of regional anesthetics, two of which are described below:
Spinal anesthetic - A spinal anesthetic is used for lower abdominal, pelvic, rectal, or lower extremity surgery. This type of anesthetic involves injecting a single dose of the anesthetic medication into the subarachnoid space, which surrounds the spinal cord. The injection is made into the lower back, below the end of the spinal cord, and causes numbness in the lower body. In some situations, such as a prolonged procedure, continuous spinal anesthesia may be used. A thin catheter (hollow tube) is left in place in the subarachnoid space for additional injections of the anesthetic agent, which ensures numbness during the length of the procedure.
Epidural anesthetic - The epidural anesthetic is similar to a spinal anesthetic and is commonly used for surgery of the lower limbs and during labor and childbirth. This type of anesthesia involves continually infusing an anesthetic medication through a thin catheter (hollow tube). The catheter is placed into the space that surrounds the spinal cord in the lower back (just outside the subarachnoid space), causing numbness in the lower body. Epidural anesthesia may also be used for chest surgical procedures. In this case, the anesthetic medication is injected at a higher location in the back to numb the chest and abdominal areas.
General anesthesia - General anesthesia is an anesthetic used to induce unconsciousness during surgery. The medication is either inhaled through a breathing mask or tube, or administered through an intravenous line (a thin plastic tube inserted into a vein, usually in the patient's forearm). A breathing tube may be inserted into the windpipe to maintain proper breathing during surgery. Once the surgery is complete, the anesthesiologist or nurse anesthetist ceases the anesthetic and the patient wakes up in the recovery room.
Once the surgery is complete, the anesthesiologist or nurse anesthetist stops the anesthetic, the medication wears off, and the patient gradually wakes up in the operating room. Complete recovery from anesthesia continues in the recovery room. Expect your child to be sleepy and to doze off often. Some children become very excited and confused when awakening from anesthesia. This reaction can be disturbing, but usually lasts only a brief time.
Post Anesthesia Care Unit (PACU)