Members of the Care Team

  • Anesthesiologist – An anesthesiologist is a physician who has earned an undergraduate degree and completed four years each of medical school and residency training in the medical specialty of anesthesiology. A pediatric anesthesiologist has additional experience or fellowship training in pediatric anesthesiology and may be board certified in both anesthesiology and pediatric anesthesiology. Additionally, many pediatric anesthesiologists also specialize in cardiac anesthesiology, pain medicine, critical care management or neuroanesthesia.
  • Anesthetist – An anesthetist is an advanced practitioner who assists an anesthesiologist in the delivery of quality anesthesia care. Anesthetists have a nursing, pre-medicine or science based undergraduate background and completed an accredited master’s program focused on the delivery and maintenance of anesthesia care and patient monitoring techniques.

Types

What are common types of anesthesia?
The two main types of anesthesia administered to children are general and sedation; the kind your child receives child depends on his or her particular procedure.

  • General Anesthesia – When general anesthesia is used, the entire body, including the brain, is put into a state of deep sleep. While in this state, your child is unconscious and has no awareness and no sensation of discomfort. During general anesthesia your child is carefully monitored and treated by his or her anesthesiologist, who uses sophisticated equipment to track all major bodily functions. Different levels of general anesthesia are used for children based on age. In some cases, your child may require intubation, where the anesthesiologists uses a tube to help your child breathe.
  • Sedation Anesthesia – With sedation anesthesia your child is deeply relaxed. He or she may be sleeping, but is able to be awakened easily and can respond to questions or physical stimulation.

Services provided

  • General Anesthesia – When general anesthesia is used, the entire body, including the brain, is put into a state of deep sleep. While in this state the patient is unconscious and has no awareness and no sensation of discomfort. During general anesthesia the patient is carefully monitored, controlled and treated by his or her anesthesiologist, who uses sophisticated equipment to track all major bodily functions.
  • Sedation Anesthesia – With sedation anesthesia the patient is deeply relaxed. He or she may be sleeping, but is able to be awakened easily and can respond to questions or physical stimulation.
  • Controlling Pain After Surgery – Many techniques are available that can help patients achieve high levels of comfort and safety following surgery, including interventional methods as well as pain medications. Pain control after surgery contributes to the healing process. If pain is not adequately controlled following surgery, patients may not be able to perform the functions necessary to heal satisfactorily. Functions like taking deep breaths, getting out of bed and walking can be difficult after surgery and sometimes require interventional pain management methods. If pain is allowed to persist the resulting inactivity can lead to severe problems such as pneumonia or an embolism.
  • Controlling Nausea and Vomiting After Surgery – While common side effects of anesthesia, nausea and vomiting after anesthesia not only makes the patient uncomfortable, but can cause significant stress on incisions and the abdominal cavity. By controlling nausea and vomiting, patients feel better and may experience decreased recovery time. Some of the techniques anesthesiologists use to control nausea and vomiting include:
    • Giving medications to prevent nausea before surgery starts in “at risk” patients
    • Maintaining nausea preventing medications throughout surgery
    • Ensuring that there are anti-nausea medications available after surgery
  • Ambulatory Care Anesthesia – Ambulatory surgery is a specialized area of care that allows patients to have surgery and then return home the same day. These centers are also called outpatient surgery centers. All types of anesthesia, including general, regional, sedation and local, can be used in an ambulatory care setting. The anesthesiologist monitors the patients closely to ensure their pain is controlled and that they are able to return home the same day.
  • Cardiovascular Anesthesia – Cardiovascular anesthesia, or cardiac anesthesia, is a unique and challenging subspecialty involving an array of complex procedures performed on patients. Cardiovascular anesthesiologists have fellowship training in anesthesia for cardiac (heart), thoracic (lungs), and vascular (blood vessels) surgeries. Cardiac patients frequently have additional medical problems such as hypertension, diabetes or lung disease, which can complicate medical management. The additional training that cardiovascular anesthesiologists receive along with state-of-the-art cardiac monitoring helps assure a safe outcome during surgery.
  • Critical Care Anesthesia – Critical care is a medical term referencing the treatment of patients with life threatening illnesses. Also known as intensive care (ICU), patients in critical care units require constant monitoring and specialized care. Anesthesiologists that specialize in critical care medicine are be able to manage anesthesia associated with acute respiratory, cardiovascular, metabolic, cerebral, and renal problems in a wide range of patients ranging from infants to older adults. They must also manage multiple organ failures, life threatening diseases and disorders that fall into many specialties.
  • Neurosurgical Anesthesia or Neurological Anesthesia – Neurosurgical anesthesia, or neuroanesthesia, focuses on patients undergoing brain or spinal cord surgery. This type of surgery is called neurosurgery. There are many similarities between neurosurgical and general anesthesia. Neuroanesthetic management, however, is different because it can have a major effect on the brain and spinal cord through the control of blood flow, blood pressure and energy consumption of these organs.
  • Orthopedic Anesthesia – Orthopedic anesthesia is a subspecialty of anesthesia that deals with the bones or skeletal system. Anesthesiologists are trained specifically to handle the complex nature of orthopedic surgery and a variety of techniques to customize care specific to the needs of orthopedic surgery patients. These techniques include, but are not limited to:
    • Special positioning to avoid intraoperative nerve injury
    • Hypotensive anesthesia, the act of inducing arterial hypotension (or an abnormally low blood pressure) to minimize blood loss
    • Isovolemic hemodilution, a mechanism to minimize blood loss
  • Pediatric and Neonatal Anesthesia – Pediatric anesthesia is a specialty with expertise, focus and sensitivity to the particular needs of children and their parents. The reason that a child needs anesthesia for procedures, like MRIs or endoscopies, is because it ensures that they will remain very still and calm. This enables the technician to obtain all the results and photos they need for the physician to diagnose and treat the child. Furthermore, the anesthesia ensures that the child will feel no pain or discomfort during the procedure.
  • Pediatric Cardiac Anesthesia – Pediatric cardiac anesthesia is a subspecialty of anesthesia specific to heart disease in children. Anesthesiologists who subspecialize in pediatric cardiac anesthesia have the training to understand the effects of anesthesia on a child with heart disease, and are experts in the management of children with congenital heart abnormalities.
  • Trauma Anesthesia – Trauma anesthesia is the subspecialty of anesthesia focused on trauma patients and their comprehensive acute requirements. All types of anesthesia including general, regional, sedation and local may be used when treating a trauma patient. 
  • Transplant Anesthesia – Transplant anesthesia is the specialty of anesthesia that manages surgeries involving organ transplants. Anesthesiologists that specialize in organ transplant anesthesia understand and have the expertise to manage both the organ recipient and the organ donor.
  • Acute Pain – Acute pain is temporary and typically results from an injury, surgery or infection. Anesthesiologists provide acute pain management services to patients during and immediately after surgery. Acute pain management is normally conducted in the hospital, but modified techniques can be offered at home with the help of a home care team. Pain management techniques include prescription medicines, nerve blocks, continuous epidurals, spinal blocks, nerve stimulators and narcotic infusions.
  • Chronic Pain – Chronic pain is reoccurring or continuous pain that persists for longer than two weeks. It is usually caused by a disease or the body’s abnormal reaction to injury or stimulus, tends to be less intense than acute pain, but can be just as debilitating. Anesthesiologists specializing in pain management have the expertise and training to be able to diagnose and treat complex pain cases. Chronic pain management techniques vary greatly from patient to patient. Some techniques used include prescription medicines, nerve blocks, continuous epidurals, spinal blocks, nerve stimulators and narcotic infusions
  • Catheters – Catheters are fine plastic tubes that are used to help anesthesiologists administer anesthesia and pain medications as a continuous infusion. These catheters are inserted near bundles of nerves to provide medications that can be used to treat post-operative pain. Local anesthetics are the usual medications that are used for catheter-treated post-operative pain. Ropivicaine is the most common local anesthetic administered through catheters. Catheters are usually placed in the pre-operative area before the start of surgery.
  • Nerve Blocks – A nerve block is a form of regional anesthesia where an anesthesia medication is injected directly next to the nerve to block the transmission of nerve signals. Common regional blocks used by anesthesiologists include:

    • Axillary Block – The axillary block is used for surgery involving areas of the upper body such as the hand, elbow or forearm.
    • Lumbar Plexus Block – The lumbar plexus block is used for surgery involving the hip, including hip replacement surgery.
    • Femoral Block – The femoral block is used for surgery involving the knee, including knee replacement and ACL reconstruction.
    • Popliteal and Saphenous Blocks - The popliteal and saphenous nerve blocks are used for surgery involving the foot and ankle.
    • Ankle Block – The ankle block is common for surgery of the foot and is administered around the ankle.
    • Bier Block – The bier block is primarily used in procedures lasting less than forty minutes that involve the arm, wrist or forearm.
    • Interscalene Block – An interscalene block is a nerve block injection around the group of nerves that supplies feeling to the arm and shoulder.
    • Spinal Block – This is a nerve block injection into the lower back where the spinal nerves are located. It will block the feeling and movement of the lower half of the body.
  • Control of Postoperative Nausea and Vomiting – While common side effects of anesthesia, nausea and vomiting after anesthesia not only makes the patient feel miserable, but can cause significant stress on incisions and the abdominal cavity. By controlling nausea and vomiting, patients feel better and may experience decreased recovery time. Some of the techniques anesthesiologists use to control nausea and vomiting include:
    • Giving medications to prevent nausea before surgery starts in “at risk” patients
    • Maintaining nausea preventing medications throughout surgery
    • Ensuring that there are anti-nausea medications available after surgery

How will you give anesthesia to my child?

Your child’s comfort is a primary concern. With younger children, we most frequently administer anesthesia through inhalation. Inhalation anesthesia allows children to breathe themselves to sleep with oxygen, nitrous oxide (laughing gas) and anesthesia gas. To make this experience more pleasant for the child, we frequently add a candy fragrance to this “magic air” mixture. Going to sleep in this manner allows the child to avoid shots. Once your child is asleep, the anesthesia team may insert an IV to provide anesthesia intravenously if a deeper sleep is necessary. The amount of anesthesia your child will receive is based on procedure type. The benefits of anesthesia are considered to outweigh any associated risks and all efforts to limit exposure are taken. If you have any questions, please speak with the physician or surgeon overseeing your child’s procedure.

 

Why does my child need anesthesia for a nonsurgical procedure?

The reason that your child needs anesthesia for nonsurgical procedures, like MRI’s or endoscopies, is because it ensures that they will remain very still and calm. This enables the clinician to obtain all the results and photos they need for the physician to diagnose and treat your child. Furthermore, the anesthesia ensures that your child will feel no pain or discomfort during the procedure.

 

How should I prepare my child for anesthesia?

Preparation for anesthesia is important and varies by type of procedure and the age of your child. Your child’s primary clinical provider will provide guidance on when and what your child can eat and drink prior to the procedure. You should also discuss any of the following items that apply to your child:

  • Current medications or herbal supplements
  • Allergies
  • Heart problems
  • Previous reactions to anesthesia

 

What can we expect on the day of my child's procedure?

Our main focus is to provide for your child’s safety and comfort during and immediately after his or her procedure, while helping provide optimal conditions for the procedure. Prior to the procedure, your child’s anesthesiologist will perform an in-depth medical history and physical exam, order or review lab tests and diagnose any potential risks to prescribe an appropriate anesthesia care plan.

Your child’s anesthesiologist will perform his or her anesthesia and your child will remain under his or her care during the procedure and recovery.

If your child has undergone a surgery, his or her recovery room stay and pain control will be directed by the anesthesiologist. When his or her pain is controlled and he or she meets criteria to leave the recovery room, they will be discharged to home or to their hospital room.

 

What do I need to know after my child’s procedure?

The physician who conducted your child’s procedure will offer recommendations regarding when your child can begin eating or drinking again, and will prescribe pain medication as needed once he or she leaves the recovery area.  

 

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